An electrode array that minimizes blood loss for radiofrequency-assisted hepatic resection

• Published in: Medical engineering & physics 2008-05, Vol.30 (4), p.454-459
• Main Authors: Schutt, D.J, O’Rourke, A.P, Will, J.A, Webster, J.G, Mahvi, D.M, Haemmerich, D
• Format: Article
• Language: English
• Subjects: Ablation; Animals; Blood Coagulation; Blood loss; Blood Loss, Surgical - prevention & control; Coagulation; Electric Impedance; Electrode array; Electrodes; Equipment Design; Hemostasis, Surgical; Hepatectomy - methods; Liver; Liver - pathology; Liver - radiation effects; Liver - surgery; Radio Waves; Radiofrequency; Radiology; Resection; Surgical Procedures, Operative - methods; Swine; Time Factors
• ISSN: 1350-4533; 1873-4030
• DOI: 10.1016/j.medengphy.2007.05.004

Abstract Hepatic resection is currently the standard treatment for liver cancer. During hepatic resection part of the liver containing the tumor is surgically removed. This type of surgery is accompanied by high blood loss of ∼0.6–1.35 L. Blood loss is associated with increased complication rates, prolonged hospital stay, and reduced patient survival, especially when transfusion is required. Other researchers have suggested using radiofrequency (rf) or microwave ablation to coagulate a tissue slice before resection to reduce blood loss, but conventional devices typically take several hours. We developed a device consisting of a linear array of blade-shaped, 1 cm wide radiofrequency (rf) electrodes 1.5 cm apart. Bipolar rf power is applied between pairs of adjacent electrodes, leading to high tissue temperatures between the electrodes that promote coagulation of large vessels (>3 mm) in the resection plane. Rapid switching of applied power between pairs of adjacent electrodes allows simultaneous heating and coagulation of the entire resection plane within 3–6 min. In seven in vivo trials in a porcine model, resection along a plane pre-coagulated with the device resulted in little (