title: A new single-instrument technique for parenchyma division and hemostasis in liver resection: a clinical feasibility study.
abstract: The objective of this study was to evaluate the clinical feasibility of a new technique for liver resection based on a radiofrequency-assisted (485 kHz) device that has shown high performance in the animal setting in both transection speed and blood loss per transection area. Eight patients with colorectal hepatic metastasis underwent 11 partial hepatectomies using the proposed technique for both parenchyma division and hemostasis. Main outcome measures were blood loss per transection area and transection speed. No other instruments (including sutures or clips) were used in any of the cases; temporary vascular occlusion performed was not performed. No blood transfusions were required and no mortality or morbidity linked to the hepatic procedure were observed. The median blood loss per transection area and the median transection speed were .79 mL/cm² (range, .05-7.37 mL/cm²) and 1.28 cm²/min (range, .49-1.87 mL/cm²), respectively. During the follow-up period (range, 4-12 mo) no late complications were detected and postoperative patients were free from hepatic recurrence. The proposed radiofrequency-assisted device was shown to achieve parenchymal division and hemostasis simultaneously, resulting in extremely reduced blood loss.
authors.affiliation: Department of Surgery, Hospital del Mar, Passeig Maritim 2529 08003, Barcelona, Spain. fburdio@hotmail.com
authors.forename: Fernando
authors.initials: F
authors.lastname: Burdío
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
authors.forename: Enrique
authors.initials: E
authors.lastname: Berjano
authors.forename: Maria
authors.initials: M
authors.lastname: Martinez-Serrano
authors.forename: Ignasi
authors.initials: I
authors.lastname: Poves
authors.forename: José M
authors.initials: JM
authors.lastname: Burdío
authors.forename: Ana
authors.initials: A
authors.lastname: Navarro
authors.forename: Antonio
authors.initials: A
authors.lastname: Güemes
mesh_terms: D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D016063:Blood Loss, Surgical; D017115:Catheter Ablation / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male
chemical_list: D001219:Aspartate Aminotransferases; D001663:Bilirubin