title: An electrode array that minimizes blood loss for radiofrequency-assisted hepatic resection.
abstract: Hepatic resection is currently the standard treatment for liver cancer. During hepatic resection part of the liver containing the tumor is surgically removed. This type of surgery is accompanied by high blood loss of approximately 0.6-1.35 L. Blood loss is associated with increased complication rates, prolonged hospital stay, and reduced patient survival, especially when transfusion is required. Other researchers have suggested using radiofrequency (rf) or microwave ablation to coagulate a tissue slice before resection to reduce blood loss, but conventional devices typically take several hours. We developed a device consisting of a linear array of blade-shaped, 1 cm wide radiofrequency (rf) electrodes 1.5 cm apart. Bipolar rf power is applied between pairs of adjacent electrodes, leading to high tissue temperatures between the electrodes that promote coagulation of large vessels (>3 mm) in the resection plane. Rapid switching of applied power between pairs of adjacent electrodes allows simultaneous heating and coagulation of the entire resection plane within 3-6 min. In seven in vivo trials in a porcine model, resection along a plane pre-coagulated with the device resulted in little (<20 mL) to no blood loss, while coagulating all vessels (up to 4.5 mm diameter in this study). Average treatment time (from placement of the device to transection) was 6.8+/-0.5 min when four electrodes were used, and 11.3+/-1.2 min when 5-7 electrodes were used. This device may reduce blood loss related morbidity during resection and reduce treatment time by coagulating all vessels in the resection plane.
authors.affiliation: Division of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Ave, Charleston, SC 29425, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Schutt
authors.forename: A P
authors.initials: AP
authors.lastname: O'Rourke
authors.forename: J A
authors.initials: JA
authors.lastname: Will
authors.forename: J G
authors.initials: JG
authors.lastname: Webster
authors.forename: D M
authors.initials: DM
authors.lastname: Mahvi
authors.forename: D
authors.initials: D
authors.lastname: Haemmerich
mesh_terms: D000818:Animals; D001777:Blood Coagulation; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D017097:Electric Impedance; D004566:Electrodes; D004867:Equipment Design; D006488:Hemostasis, Surgical; D006498:Hepatectomy / Q000379:methods; D008099:Liver / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery*; D011846:Radio Waves; D013514:Surgical Procedures, Operative / Q000379:methods; D013552:Swine; D013997:Time Factors