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We have performed hepatectomy using microwave tissue coagulator which we have developed in about 122 patients with liver cancer associated with cirrhosis. Merit of this high hemostatic performance has been put to use from the first and operations with this have been considered to be those which hardly require transfusion during operation. We introduce you the keys and points to be regarded of recent operative technique. Points in operation can be summarized as follows : 1. Portal blocking is not made, 2. Cholecystectomy is made and a catheter is placed in the cystic duct, 3. The line for incision is determined previously by ultrasonography, 4. Coagulation is made mimutely, strongly and in no hurry(80W. 45s), 5. A line for incision is determined to leave coagulation zone which extends from the electrode impaling site to 10 mm thereof sufficiently on the side of the remaining liver. 6. Coagulation in the neighborhood of large vessels is avoided, 7. Even though cutting suture occurred at the ligature of small vessel systems, Z-type ligature is applied afterward, 8. When the resection is finished the absence of stump bleeding is confirmed and then indigocamine is infused from a tube which is placed previously and biliary leakage test is made without fail, 9. Omentopexy is made without fail to remove a dead space between the subdiaphragmatic surface and liver. 10. The drain is removed as early as possible to prevent retrograde infection.

In Japan there are more than 15000 patients with cardiac pacemaker in a year. General surgical procedures in pacemaker patients have become common in recent years. General surgeon must have enough knowledge about surgical problem in pacemaker patients. It has been one of the important problem that the use of electrocautery sometimes interferes in the heart rhythm by pacemaker although there is no report, whether microwave scalpel has influence on the pacemaker rhythm or not. Recently we have alternately used electrocautery and new microwave scalpel (Blade type) on same patient during gastrectomy. In this paper, The influence of the electrocautery and microwave scalpel on the pacemaker function is reported respectively. It is demonstrated that a microwave scalpel has not influenced on the pacemaker rhythm as compared with electrocautery.

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