Inline Radiofrequency Ablation‐assisted Laparoscopic Liver Resection: First Experiment With Stapling Device

Yao, Peng; Gunasegaram, Aravin; Ladd, Leigh A.; Chu, Francis; Morris, David L.

doi:10.1111/j.1445-2197.2007.04099.x

Cited by 11 publications

(12 citation statements)

References 42 publications

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“…Backflow bleeding could be immediately managed by a temporary increase of pneumoperitoneum pressure up to 20 mmHg. Finally, if some of the analyzed EDs have been used to transect portal structures, none of them have been clearly assessed for biliostasis . A specific trial focusing on ED and biliostasis is highly required.…”

Section: Discussionmentioning

confidence: 99%

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

Scatton

Brustia

Belli

et al. 2015

J Hepatobiliary Pancreat Sci

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Transection methods and hemostasis achievement have an impact on blood loss, and consequently on outcome and survival. However, no consensus exists on parenchymal transection or hemostasis techniques in laparoscopic liver resection (LLR). The aim of this review is to clarify the role of energy devices (ED) in LLR. ED is a generator of mechanic or electric energy transfer to an operating tool, used for transection, sealing or both. Searches were performed in PubMed, PubMed Central, Cochrane, Embase, Google Scholar in human or animal experimental models. Each study quality was graded following the GRADE system. From 1996 to 2014, 30 studies were found: five comparative, one prospective, two case-control, and 16 case series and some case reports, with level of evidence ranging from Moderate to Very Low. Since 2012, the Research and Development of new tools raised quicker than clinical studies could follow. The two main techniques emerged are blind transection versus sharp dissection: due to the low quality and heterogeneity of the studies, no firm conclusion can be drawn, but meticulous dissection of vessels usually never leads to vascular damage. As a matter of fact, ED, though efficient and reliable, cannot replace the basic skills of hepatic surgery: sharp dissection, vascular control and elective sealing.

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Section: Discussionmentioning

confidence: 99%

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

Scatton

Brustia

Belli

et al. 2015

J Hepatobiliary Pancreat Sci

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“…Our working panel, composed by experts in the field of LLR, deeply believes that surgeons should be experienced with the use of all surgical devices for liver transection and should distinguish between dissection tools and section tools. Interestingly enough, the only transection device that has been proved to be associated with superior surgical outcomes during LLR is the precoagulation with monopolar or bipolar radiofrequency [29]. In fact, precoagulation is not a dissection or section tool but rather an instrument that can be associated to a transection device in order to decrease bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the swine model has been used in order to prospectively demonstrate that multiple gas embolism (CO 2 ) frequently occur during LLR [26,27] (Grade B) without significant modification of hemodynamics [27] (Grade B). [29] 2007 ANZ J Surg Use of inline RF for liver transection Navarro et al [62] 2008 Surg Endosc Use of a new RF-assisted device for liver transection Jayaraman et al [27] 2009 …”

Section: Pneumoperitoneummentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

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Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

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“…The bipolar InLine radiofrequency ablation (ILRFA) device is originally designed to rapidly precoagulate the liver parenchyma of a resection plane. In our previous researches of liver surgery, we have shown that using the ILRFA device could significantly reduce blood loss both in animal models and in clinical studies and not increase the risk of the occurrence of postoperative complications (liver failure and bile leak) 6,7 . In this study, we tested the ILRFA‐assisted partial nephrectomy in a porcine model.…”

Section: Introductionmentioning

confidence: 99%

Inline Bipolar Radiofrequency Ablation Device‐assisted Partial Nephrectomy in a Porcine Model

Yao

Gunasegaram

Ladd

et al. 2008

ANZ Journal of Surgery

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Inline Radiofrequency Ablation‐assisted Laparoscopic Liver Resection: First Experiment With Stapling Device

Abstract: In this study, we successfully carried out InLine RFA-assisted laparoscopic liver resection in both stapled and diathermy group. We showed that there was a highly significant difference between InLine and other liver resection techniques laparoscopically.

Cited by 11 publications

References 42 publications

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

Bleeding control during laparoscopic liver resection: a review of literature

Inline Bipolar Radiofrequency Ablation Device‐assisted Partial Nephrectomy in a Porcine Model

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