A radiofrequency-assisted device for bloodless rapid transection of the liver: a comparative study in a pig liver model

Eur J Surg Oncol. 2008 May;34(5):599-605. doi: 10.1016/j.ejso.2007.05.008. Epub 2007 Jul 5.


Background: Efficient and safe liver parenchymal transection is dependent on the ability to address both parenchymal division and hemostasis simultaneously. In this article we describe and compare with a saline-linked instrument a new radiofrequency (RF)-assisted device specifically designed for tissue thermocoagulation and division of the liver used on an in vivo pig liver model.

Methods: In total, 20 partial hepatectomies were performed on pigs through laparotomy. Two groups were studied: group A (n=8) with hepatectomy performed using only the proposed RF-assisted device and group B (n=8) with hepatectomy performed using only a saline-linked device. Main outcome measures were: transection time, blood loss during transection, transection area, transection speed and blood loss per transection area. Secondary measures were: risk of biliary leakage, tissue coagulation depth and the need for hemostatic stitches. Tissue viability was evaluated in selected samples by staining of tissue NADH.

Results: In group A both blood loss and blood loss per transection area were lower (p=0.001) than in group B (70+/-74 ml and 2+/-2 ml/cm(2) vs. 527+/-273 ml and 13+/-6 ml/cm(2), for groups A and B, respectively). An increase in mean transection speed when using the proposed device over the saline-linked device group was also demonstrated (3+/-0 and 2+/-1cm(2)/min for group A and B, respectively) (p=0.002). Tissue coagulation depth was greater (p=0.005) in group A than in group B (6+/-2 mm and 3+/-1 mm, for groups A and B, respectively). Neither macroscopic nor microscopic differences were encountered in transection surfaces between both groups.

Conclusions: The proposed RF-assisted device was shown to address parenchymal division and hemostasis simultaneously, with less blood loss and faster transection time than saline-linked technology in this experimental model.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Catheter Ablation / instrumentation*
  • Catheter Ablation / methods
  • Hemostatic Techniques
  • Hepatectomy / methods*
  • Liver / surgery*
  • Models, Animal
  • Swine