Controlled study of inline radiofrequency ablation (ILRFA) assisted transection of ovine liver

Background. Liver resection is now a standard treatment for primary and secondary hepatic tumors around the world. Intra-operative blood loss during liver resection is a major factor associated with morbidity and mortality. We have developed a new instrument using radiofrequency energy (ILRFA), which is intended to achieve coagulative ablation in a plane. This plane can then be cut through with a scalpel, ultrasonic dissector, or diathermy with minimal blood loss. Materials and methods. Five sheep were used in this non-recovery experiment. In these sheep we performed five liver resections with the ILRFA and five similar resections using diathermy and suturing as control. Blood loss was measured by determining the difference in the weights of dry sponges and blood stained sponges after resection. Results. ILRFA was successful in achieving coagulative ablation in all cases to a width of 1 cm. The mean blood loss in ILRFA was 43.2 g (SD36) and 221.8 g (SD147) in the control group. The bleeding was significantly reduced in ILRFA group with a P value of 0.005. Conclusions. Bleeding remains an important complication of liver resection. To reduce bleeding during liver surgery, different techniques have been used. In this study, we have demonstrated that by using ILRFA we can perform liver resections in sheep with minimal blood loss. (C) 2004 Elsevier Inc. All rights reserved.