Liver Resection Assisted with the Radiofrequency Technique

Abstract

Liver surgery remains the gold standard for the treatment of liver tumours. To aid with hepatic resection, several devices have been developed in an attempt to stem significant blood loss and reduce the necessity for vascular exclusion. Of note are the Harmonic scalpel, bipolar scissors, hydrodissectors, Ligasure diathermy, Cavitron ultrasonic aspirator (CUSA) and Monopolar floating ball. However, most of these devices still require some degree of vascular inflow occlusion or are time consuming and none, except radiofrequency, can also be used to successfully ablate tumours. Furthermore, vascular occlusion- whether it is intermittent, continuous, partial or total- affects postoperative function of the hepatic remnant, especially in those patients treated with neo-adjuvant chemotherapy or in those patients with underlying chronic liver disease. Of all the new techniques now being applied to liver surgery the most successful and versatile is radiofrequency, which, until recently, was used only for in situ ablation of unresectable tumours