Techniques of radiofrequency-assisted precoagulation in laparoscopic liver resection

Abstract

We have suggested an algorithm to select a given device based on tumor location and type of resection. With approximately 30 min of time spent for precoagulation, the blood loss and rate of local recurrence were favorable. There also could be an oncologic benefit due to additional functional margin obtained with the RF effect.

Laparoscopic liver re-resection is feasible for patients with posthepatectomy hepatocellular carcinoma recurrence: a propensity score matching study

“…This technique ensures an ablated margin left behind and improves oncological radicality. In addition, such a precoagulation process can be performed percutaneously without any violation of the minimally invasiveness and benefits to the subsequent laparoscopic liver resection [27][28][29]. This approach is not routinely used by us for fear of complications such as vessel thrombosis, biliary injury and bleeding on withdrawal of the needle [30].…”

A systematic review on radiofrequency assisted laparoscopic liver resection: Challenges and window to excel

“…Monopolar consisted of different Cool-tip RF ablation systems, which were used in 7 studies 11,19,[21][22][23][24][25] , and the StarBurst XL RF ablation device, employed in only 1 study together with a bipolar device (Habib 4X Laparoscopic) 26 . Three bipolar devices were used; [27][28][29] the Habib 4X Laparoscopic (also named Habib Sealer) was used in 5 studies 17,18 , whilst the InCircle B-RFA and Inline RF coagulation were used in one study each 20,30 .…”

“…One study (Akyildiz et al 2011) 26 describing results from the use of two different devices, monopolar and bipolar, has compared reported intraoperative haemorrhage. The mean intraoperative blood loss was greater in the monopolar group (224 cc ± 79 cc) than in the bipolar (89 cc ± 77 cc), however, this difference was not statistically significant.…”

“…The requirement of blood transfusions was reported in 13 studies with 12 reporting no blood transfusion due to minimal blood loss [17][18][19][20][21][22][23][25][26][27][28][29] . The two patients who required higher blood transfusion has been reported by Alemi et al 2011 in their series because of the intraoperative blood loss ranging up to 3000 ml 30 .…”

Bleeding control during laparoscopic liver resection: a review of literature

“…[66] 2011 Surg Endosc Precoagulation by mono or bipolar RF for liver transection Kobayashi et al [34] 2011 Surg Endosc Use of fibrin sealant at the cut liver surface Packiam et al [67] 2012 J Gastrointest Surg Robotic LLR Patriti et al [68] 2012 Updates Surg Comparing intermittent Pringle maneuver versus no clamping in robotic LLR Tan et al [31] 2012 J Laparoendosc Adv Surg Tech A Use of intermittent Pringle, hemihepatic clamping and selective clamping Tranchart et al [6] 2013 Am J Surg Prior vascular control Ji et al [69] 2004 Chir Gastroenterol Multifunctional device used during liver transection Retrospective series Toyama et al [23] 2006 J Hepatobiliary Pancreat Surg…”