A device for radiofrequency assisted hepatic resection

Hepatic resection is the current standard treatment for hepatic malignancies. During hepatic resection part of the liver containing the tumor is surgically removed. This type of surgery is associated with high blood loss of /spl sim/1 L. Blood loss is associated with increased complication rates, prolonged hospital stay and reduced patient survival, especially when transfusion is required. We present a device that allows coagulation of a plane of tissue 1 to 2 cm wide, including coagulation of large vessels. This enables reduction of blood loss to a minimum by performing surgery along the coagulated tissue plane. The device consists of a linear array of radiofrequency (RF) electrodes 1.5 cm apart. By application of RF current in bipolar mode between two adjacent electrodes, temperatures close to 100 /spl deg/C are obtained in-between electrodes enabling coagulation of large vessels. Rapid switching of applied current between all adjacent electrode pairs enables rapid heating of a tissue slice. We present a prototype device including results from ex vivo and in vivo experiments.

I. Introduction

Surgical resection is the current standard treatment for both primary and metastatic liver cancer. Depending on technique, either one of the two liver lobes is surgically removed (anatomical resection), or part of a lobe is removed (partial resection). Surgical resection is associated with high interoperative blood loss, with mean blood loss between 600 mL and 1300 mL [1], [2], with 28 to 47% of the patients requiring blood transfusion [1], [3]. Several studies have shown that blood loss correlates adversely with length of hospital stay, complication rate, and patient survival [4], [5]. Especially when transfusion is required, patient prognosis is affected detrimentally, probably due to immunosuppression [6]. Further reduction in interoperative blood loss is therefore advocated by many surgeons.