title: Hepatic resection using heat coagulative necrosis. First report of successful trisegmentectomy after hypertrophy induction.
abstract: BACKGROUND
  Intraoperative blood loss has been identified as one of the major mortality predictors for liver surgery. Different strategies have been used in the past to minimize blood loss during resection. A new method using heat coagulative necrosis in healthy tissue at the resection plane to achieve a bloodless resection has been described 3 years ago and has already gained acceptance for peripheral resections. A further developmental stage of this method is now available with the so-called Habib 4x sealer. So far, only resections ranging from segmentectomies to hemihepatectomies are reported.
  
  
  METHODS
  In the case reported here, the new method was challenged to perform an extended hepatic resection in a patient suffering from colorectal liver metastases. The resection was performed in a hybrid technique of regular hilar preparation and parenchymal dissection using the sealer.
  
  
  CONCLUSIONS
  The method showed to be safe and efficient even for an extended resection.
authors.affiliation: Department of General and Visceral Surgery, Celle General Hospital, Siemensplatz 4, 29223 Celle, Germany. stavrou@liversurgery.de
authors.forename: Gregor A
authors.initials: GA
authors.lastname: Stavrou
authors.forename: Z
authors.initials: Z
authors.lastname: Tzias
authors.forename: C
authors.initials: C
authors.lastname: von Falck
authors.forename: N
authors.initials: N
authors.lastname: Habib
authors.forename: K-J
authors.initials: KJ
authors.lastname: Oldhafer
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D004564:Electrocoagulation / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D006984:Hypertrophy; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D009336:Necrosis