Abstract
Background/Aims: Intraoperative bleeding is a major concern in liver surgery and traditionally portal triad clamping (PTC) has been applied to reduce blood loss. However, this benefit is counterbalanced by the adverse effects of warm ischemia-reperfusion liver injury. The ideal alternative would be to use modern energy devices that minimize bleeding, without needing PTC. One such novel device is the InLine® multichannel radiofrequency device (ILMRD, Resect Medical, Inc., Fremont, CA) that produces coagulative necrosis along the transection plane. Methodology: In the present paper we reviewed 24 consecutive hepatic resections (18 metastases, 5 hepatoma, 1 focal nodular hyperplasia) performed with aid of ILMRD. Statistical analyses were performed with Mann-Whitney and Fisher Exact tests. Results: The mean blood loss was 240ml (range 50-750ml) with only 2 patients requiring blood transfusions. For the first 8 cases the median PTC time was 16 minutes, and in the subsequent 16 cases, not only was there a significant decline in the median clamp time (0 min, p=0.026) but also in the frequency of PTC use (71% vs. 11%, p=0.008). A significant reduction in blood loss was seen when comparing the first 8 versus the subsequent 16 cases (median 350ml vs. 112ml, p=0.016). The median length of hospital and intensive care unit stay for the cohort were 7 and 1 days, respectively. There were no deaths and the major morbidity rate was 16.7%. Conclusion: The use of ILMRD is an innovative approach to minimize blood loss and PTC during parenchymal transection phase of hepatic resection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1496-1500 |
| Number of pages | 5 |
| Journal | Hepato-Gastroenterology |
| Volume | 56 |
| Issue number | 94-95 |
| State | Published - 2009 |
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Keywords
- Bipolar electrode
- Hemorrhage
- Hepatectomy
- In-line device
- Radiofrequency coagulation
- Radiofrequency-assisted liver resection
ASJC Scopus subject areas
- Gastroenterology
- Hepatology
Cite this
Radiofrequency-assisted hepatectomy using bipolar inline® multichannel radiofrequency device (ILMRD) : Report of initial clinical experience. / Kargozaran, Hamed; Wildendorf, Stephen; Khatri, Vijay P.
In: Hepato-Gastroenterology, Vol. 56, No. 94-95, 2009, p. 1496-1500.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiofrequency-assisted hepatectomy using bipolar inline® multichannel radiofrequency device (ILMRD)
T2 - Report of initial clinical experience
AU - Kargozaran, Hamed
AU - Wildendorf, Stephen
AU - Khatri, Vijay P.
PY - 2009
Y1 - 2009
N2 - Background/Aims: Intraoperative bleeding is a major concern in liver surgery and traditionally portal triad clamping (PTC) has been applied to reduce blood loss. However, this benefit is counterbalanced by the adverse effects of warm ischemia-reperfusion liver injury. The ideal alternative would be to use modern energy devices that minimize bleeding, without needing PTC. One such novel device is the InLine® multichannel radiofrequency device (ILMRD, Resect Medical, Inc., Fremont, CA) that produces coagulative necrosis along the transection plane. Methodology: In the present paper we reviewed 24 consecutive hepatic resections (18 metastases, 5 hepatoma, 1 focal nodular hyperplasia) performed with aid of ILMRD. Statistical analyses were performed with Mann-Whitney and Fisher Exact tests. Results: The mean blood loss was 240ml (range 50-750ml) with only 2 patients requiring blood transfusions. For the first 8 cases the median PTC time was 16 minutes, and in the subsequent 16 cases, not only was there a significant decline in the median clamp time (0 min, p=0.026) but also in the frequency of PTC use (71% vs. 11%, p=0.008). A significant reduction in blood loss was seen when comparing the first 8 versus the subsequent 16 cases (median 350ml vs. 112ml, p=0.016). The median length of hospital and intensive care unit stay for the cohort were 7 and 1 days, respectively. There were no deaths and the major morbidity rate was 16.7%. Conclusion: The use of ILMRD is an innovative approach to minimize blood loss and PTC during parenchymal transection phase of hepatic resection.
AB - Background/Aims: Intraoperative bleeding is a major concern in liver surgery and traditionally portal triad clamping (PTC) has been applied to reduce blood loss. However, this benefit is counterbalanced by the adverse effects of warm ischemia-reperfusion liver injury. The ideal alternative would be to use modern energy devices that minimize bleeding, without needing PTC. One such novel device is the InLine® multichannel radiofrequency device (ILMRD, Resect Medical, Inc., Fremont, CA) that produces coagulative necrosis along the transection plane. Methodology: In the present paper we reviewed 24 consecutive hepatic resections (18 metastases, 5 hepatoma, 1 focal nodular hyperplasia) performed with aid of ILMRD. Statistical analyses were performed with Mann-Whitney and Fisher Exact tests. Results: The mean blood loss was 240ml (range 50-750ml) with only 2 patients requiring blood transfusions. For the first 8 cases the median PTC time was 16 minutes, and in the subsequent 16 cases, not only was there a significant decline in the median clamp time (0 min, p=0.026) but also in the frequency of PTC use (71% vs. 11%, p=0.008). A significant reduction in blood loss was seen when comparing the first 8 versus the subsequent 16 cases (median 350ml vs. 112ml, p=0.016). The median length of hospital and intensive care unit stay for the cohort were 7 and 1 days, respectively. There were no deaths and the major morbidity rate was 16.7%. Conclusion: The use of ILMRD is an innovative approach to minimize blood loss and PTC during parenchymal transection phase of hepatic resection.
KW - Bipolar electrode
KW - Hemorrhage
KW - Hepatectomy
KW - In-line device
KW - Radiofrequency coagulation
KW - Radiofrequency-assisted liver resection
UR - http://www.scopus.com/inward/record.url?scp=71949097343&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=71949097343&partnerID=8YFLogxK
M3 - Article
C2 - 19950816
AN - SCOPUS:71949097343
VL - 56
SP - 1496
EP - 1500
JO - Acta hepato-splenologica
JF - Acta hepato-splenologica
SN - 0172-6390
IS - 94-95
ER -