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

Schutt, D.J.; O’Rourke, A.P.; Will, J.A.; Webster, J.G.; Mahvi, D.M.; Haemmerich, D.

doi:10.1016/j.medengphy.2007.05.004

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Volume 30, Issue 4 , Pages 454-459, May 2008

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

D.J. Schutt
- Division of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Ave, Charleston SC 29425, USA
A.P. O’Rourke
- Department of Surgery, University of Wisconsin-Madison, WI, USA
J.A. Will
- Department of Animal Health and Biomedical Sciences, University of Wisconsin-Madison, WI, USA
J.G. Webster
- Department of Biomedical Engineering, University of Wisconsin-Madison, WI, USA
D.M. Mahvi
- Department of Surgery, University of Wisconsin-Madison, WI, USA
D. Haemmerich
- Division of Pediatric Cardiology, Medical University of South Carolina, 165 Ashley Ave, Charleston SC 29425, USA
- Department of Bioengineering, Clemson University, SC, USA
- Corresponding author at: 165 Ashley Ave, PO Box 250915, Charleston SC 29425, USA. Tel.: +1 843 792 1396.

Received 2 November 2006; received in revised form 20 February 2007; accepted 4 May 2007. published online 25 June 2007.

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 ∼0.6–1.35L. 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, 1cm wide radiofrequency (rf) electrodes 1.5cm 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 (>3mm) 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 3–6min. In seven in vivo trials in a porcine model, resection along a plane pre-coagulated with the device resulted in little (<20mL) to no blood loss, while coagulating all vessels (up to 4.5mm diameter in this study). Average treatment time (from placement of the device to transection) was 6.8±0.5min when four electrodes were used, and 11.3±1.2min when 5–7 electrodes were used. This device may reduce blood loss related morbidity during resection and reduce treatment time by coagulating all vessels in the resection plane.