title: Radiofrequency on the liver remnant after liver resection to reach the haemostasis not otherwise achievable with conventional techniques.
abstract: BACKGROUND
  During liver resection, in same case of inflamed, steatotic or neo-vascularized liver parenchyma, reaching of haemostasis on the liver resection surface could be very difficult for the surgeon because of the presence of fragile tissue that does not allows the proper placement of stitches, and the conventional method fail.
  
  
  METHODS
  The authors describe a novel technique in which, after a formal liver resection, liver haemostasis is achieved using radiofrequency energy on the resected surface. A patient affected by a hystiocytic sarcoma localized on the VI-V and IVa segments was scheduled for liver resection. During the resection a diffuse bleeding from the resected surface started with little success obtained with conventional method. So we decided to use the coagulative necrosis generated by the radiofrequency, using a cool type cluster needle, hand-piece with 3 needle, bending 2 needles in a way resembling a "fork", to reach a complete and definitive haemostasis.
  
  
  CONCLUSIONS
  Haemostasis remains a critical issue in liver surgery not only for the catastrophic effect of haemorrhage but also because it is correlated to complications rate and to survival. The coagulative necrosis generated by the radiofrequency could be used to facilitate the creation of a necrotic plane to be transacted.
  
  
  CONCLUSIONS
  The use of the radiofrequency energy, delivered through needles, is suggested when the conventional techniques fail to reach a proper haemostasis after a liver resection or, to consider its use, prior to resect the liver in presence of fragile parenchyma.
authors: Digestive Surgery Unit, Department of Surgery and Traslational Medicine, University of Florence Medical School, Careggi University Hospital, Florence, Italy. Electronic address: benedettaps@gmail.com.
authors: Benedetta
authors: B
authors: Pesi
authors: Francesca
authors: F
authors: Leo
authors: Gadiel
authors: G
authors: Liscia
authors: Giovanni
authors: G
authors: Alemanno
authors: Daniela
authors: D
authors: Zambonin
authors: Massimo
authors: M
authors: Falchini
authors: Giacomo
authors: G
authors: Batignani
references: Am J Surg. 2005 Jul;190(1):43-7
references: 15972170
references: Ann Surg. 2004 Oct;240(4):698-708; discussion 708-10
references: 15383797
references: World J Surg. 2007 Nov;31(11):2208-12; discussion 2213-4
references: 17879113
references: Ann Surg. 2002 Nov;236(5):560-3
references: 12409660
references: HPB (Oxford). 2007;9(3):166-73
references: 18333217
references: HPB (Oxford). 2007;9(1):37-41
references: 18333111
references: HPB (Oxford). 2008;10(4):256-60
references: 18773112