New technique for liver resection using heat coagulative necrosis.

Radiofrequency (RF) ablation has been widely used in the past few years ablating unresectable liver tumors.2 Using the same principle, we have developed and reported a new liver resection technique with radiofrequency by creating a zone of necrosis along a line of intended division of liver parenchyma.Since description of RF-assisted liver resection technique,1 we have applied this to all hepatic resections performed in our unit, including cases with more than 5 tumorectomies and tumors up to 125 mm in size. More than 30 major resections of more than 3 segments based on Couinaud's classification have been performed with the RF-assisted technique in the past few years. We shall be shortly submitting the result of RF-assisted liver resection for publication. For major liver resection, the hilus was dissected to ligate arterial and portal branches of the resected part. Hepatic veins were then either coagulated with RF or ligated pending on the site of tumor and resection. The median resection time was 90 minutes, with a median blood loss of less than 200 mL. There has been no postoperative intensive care admission, and hospital stay has also been shortened considerably. Very few cases had postoperative bile leakage or liver failure. We think that RF-assisted liver resection is safe, effective, and reasonably rapid, and the technique may be applicable to other solid and vascular organs such as the spleen and kidney. Based on this technique, a “Habib sealer” has recently been developed and used clinically, which has been shown to be more effective in reduction of ablation and resection time than conventional RF.