Radiofrequency-assisted hemostasis in a trauma model: a new indication for a bipolar device.
BACKGROUND
Hemorrhage control in severe splenic and hepatic injuries remains a challenge, despite recent improvements in equipment technology. Radiofrequency (RF) energy-assisted surgery for the spleen and liver has been recently reported; however, the technique has not gained wide acceptance, mainly due to surgeons' unfamiliarity with the technique and the risk of complications caused by uncontrolled disseminated energy. In this study, the safety and efficacy of the Habib 4X (AngioDynamics, Latham, NY), a hand-held bipolar RF energy device, was evaluated in a porcine trauma model.


METHODS
Five white male Landrace pigs were included in the study. Multiple stab wounds were inflicted to the splenic and hepatic parenchyma, both centrally and peripherally. Hemostasis was achieved by using the Habib 4X RF bipolar device. The pigs were humanely sacrificed 6 weeks postoperatively, and histology of the ablated spleen and liver was evaluated.


RESULTS
Hemorrhage was successfully controlled at all bleeding sites, using appropriate RF generator settings. The splenic artery and vein, as well as the hepatic veins, were successfully ligated using the device. No complications were noted immediately postoperatively or 6 weeks following the procedure.


CONCLUSIONS
The bipolar Habib 4X device delivers RF energy that can achieve hemostasis of the injured splenic and hepatic parenchyma. The method is feasible and safe. Clinical studies are warranted to assess short- and long-term results of this promising technique and compare it to the gold standards.
Zacharoulis
Dimitris
D
Department of Surgery, University Hospital of Larissa, Larissa, Greece. zachadim@yahoo.com
Lazoura
Olga
O
Sioka
Eleni
E
Tzovaras
George
G
Rountas
Christos
C
Spiropoulos
Spiridon
S
Zahari
Eleni
E
Chatzitheofilou
Costas
C
D000007:Abdominal Injuries / Q000150:complications / Q000601:surgery*; D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation; D004195:Disease Models, Animal; D005240:Feasibility Studies; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D008099:Liver / Q000293:injuries / Q000601:surgery*; D008297:Male; D013154:Spleen / Q000293:injuries / Q000601:surgery*; D013552:Swine; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000150:complications / Q000601:surgery*