A toroidial-shaped HIFU transducer for assisting hepatic resection: a complementary tool for surgery

• Main Authors: N'Djin, W A, Melodelima, D, Schenone, F, Rivoire, M, Chapelon, J Y
• Format: Conference Proceeding
• Language: English
• ISSN: 0094-243X
• DOI: 10.1063/1.3131401

A toroidial-shaped HIFU medical device with integrated ultrasound imaging was developed for the treatment of colorectal liver metastasis. The HIFU toroidial-shaped transducer contained 256-elements (working frequency: 3 MHz) and allows creating a single conical lesion of 7 cm3 in 40 seconds (Ifocal = 1700 W.cm-2). Volumes of treatment can then be significantly increase by juxtaposing single lesions. Presented here is the use of this device in an animal model as a complementary tool to improve surgical resection in the liver. A zone of coagulative necrosis before transecting the liver was performed using this device in order to minimize blood loss and dissection time during hepatectomy. Resection assisted by HIFU (RA-HIFU) was compared with classical dissections with clamping (RC) and without clamping (Control). For each technique 14 partial liver resections were performed in seven pigs. Blood loss per dissection surface area was the main outcome parameter. Blood loss during liver transection was significantly lower in RA-HIFU (7.4+/-3.3 ml.cm-2) than in RC (34%) and Control (47%). The duration of transection in RA-HIFU (13+/-3 min) was significantly shorter than in RC (44%) and Control (28%). Precoagulation also resulted in the use of significantly fewer clips; the number of clips used per square centimetre was 50% lower in RA-HIFU (0.8+/-0.2 cm-2) than in the other groups.