title: Laparoscopic treatment of liver tumours using a two-needle probe bipolar radiofrequency ablation device.
abstract: BACKGROUND
  Many hepatobiliary centres are increasingly utilizing thermocoagulative devices such as bipolar-radiofrequency ablation (B-RFA). Compared with monopolar-radiofrequency ablation (M-RFA), B-RFA does not require grounding pads, thereby avoiding dermal burn injuries, and does not position probes directly into the tumour but rather on the perimeter. Additionally, B-RFA can precoagulate parenchyma to assist in hepatic resection. Herein, we report our early experience using B-RFA.
  
  
  METHODS
  A retrospective review identified 68 patients who underwent M-RFA or B-RFA between June 2004 and September 2010 in an academic centre. Peri-operative metrics were analysed.
  
  
  RESULTS
  M-RFA was used to treat 30 patients, whereas B-RFA was used for 17 patients. There were no differences in peri-operative metrics, survival or disease recurrence between M-RFA and B-RFA. Seventeen additional patients underwent B-RFA precoagulation during laparoscopic resection (segmentectomy in eleven patients and multi-segmental resection in six patients). Four patients with multifocal disease underwent procedures that combined B-RFA with resection.
  
  
  CONCLUSIONS
  The early experience utilizing B-RFA demonstrates equivalency to M-RFA with respect to peri-operative metrics and survival. Moreover, B-RFA can be utilized to precoagulate tissue during a planned resection, making it not only a useful tool for tumour therapy but also a useful adjunct during surgical resections.
authors.affiliation: Department of Surgery, University of California, and San Francisco VA Medical Center, San Francisco, CA 94121, USA.
authors.forename: Farzad
authors.initials: F
authors.lastname: Alemi
authors.forename: Edwin
authors.initials: E
authors.lastname: Kwon
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chiu
authors.forename: Hisae
authors.initials: H
authors.lastname: Aoki
authors.forename: Lygia
authors.initials: L
authors.lastname: Stewart
authors.forename: Carlos U
authors.initials: CU
authors.lastname: Corvera
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012495:San Francisco; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome