A radiofrequency-assisted device for bloodless rapid transection of the liver: A comparative study in a pig liver model (original) (raw)
2008, European Journal of Surgical Oncology (EJSO)
Background: Efficient and safe liver parenchymal transection is dependent on the ability to address both parenchymal division and hemostasis simultaneously. In this article we describe and compare with a saline-linked instrument a new radiofrequency (RF)-assisted device specifically designed for tissue thermocoagulation and division of the liver used on an in vivo pig liver model. Methods: In total, 20 partial hepatectomies were performed on pigs through laparotomy. Two groups were studied: group A (n ¼ 8) with hepatectomy performed using only the proposed RF-assisted device and group B (n ¼ 8) with hepatectomy performed using only a salinelinked device. Main outcome measures were: transection time, blood loss during transection, transection area, transection speed and blood loss per transection area. Secondary measures were: risk of biliary leakage, tissue coagulation depth and the need for hemostatic stitches. Tissue viability was evaluated in selected samples by staining of tissue NADH. Results: In group A both blood loss and blood loss per transection area were lower ( p ¼ 0.001) than in group B (70 AE 74 ml and 2 AE 2 ml/ cm 2 vs. 527 AE 273 ml and 13 AE 6 ml/cm 2 , for groups A and B, respectively). An increase in mean transection speed when using the proposed device over the saline-linked device group was also demonstrated (3 AE 0 and 2 AE 1 cm 2 /min for group A and B, respectively) ( p ¼ 0.002). Tissue coagulation depth was greater ( p ¼ 0.005) in group A than in group B (6 AE 2 mm and 3 AE 1 mm, for groups A and B, respectively). Neither macroscopic nor microscopic differences were encountered in transection surfaces between both groups. Conclusions: The proposed RF-assisted device was shown to address parenchymal division and hemostasis simultaneously, with less blood loss and faster transection time than saline-linked technology in this experimental model.
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