Research and development of a new RF-assisted device for bloodless rapid transection of the liver: Computational modeling and in vivo experiments

Burdı́o, Fernando; Berjano, Enrique; Navarro, Ana; Burdío, J.M.; Grande, Luís; González, Ángel Poncela; Cruz, Ignacio; Güemes, Antonio; Sousa, Ramón; Subirá, Jorge; Castiella, Tomás; Poves, Ignasi; Lequerica, J.L.

doi:10.1186/1475-925x-8-6

Cited by 30 publications

(17 citation statements)

References 30 publications

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“…The effect of free convection at the tissue-ambient and device-ambient interfaces was taken into account using a thermal 245 transfer coefficient (h e ) of 20 W m −2 K −1 and a value of 21ºC was considered for ambient temperature. 25 The cooling effect produced by the fluid circulating inside the device was not modeled realistically by means of internal tubes (the device was empty, …”

Section: Iic Computer Modelingmentioning

confidence: 99%

Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF‐assisted surgical resection?

et al. 2014

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A.; Trujillo Guillen, M.; Andaluz, A.; Berjano, E. (2014). Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF-assisted surgical resection?. Medical Physics. 41 (8) the cases considered. Thermal damage to the portal vein wall was inversely related to the vessel-device distance. It was also more pronounced when the device-tissue contact surface was reduced or when the vessel was parallel to the device or perpendicular to its distal end (blade zone), the vessel wall being damaged at distances less than 4.25 mm. Conclusions:Our computational findings suggest that the heat sink effect could protect 40 the portal vein wall for distances equal to or greater than 5 mm, regardless of its position and distance with respect to the RF-based device.

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Section: Iic Computer Modelingmentioning

confidence: 99%

Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF‐assisted surgical resection?

et al. 2014

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“…Experiments were conducted in these studies to determine convective heat transfer coefficients in the heart as well as the heart tissue properties [8][9][10]. Much of the subsequent research drew heavily on this initial work for geometry, tissue properties and convection coefficients for blood flow in the heart, notably Berjano and co-workers [4,[11][12][13][14]. A proven computational model strategy has emerged from the research and several aspects of that model will be considered in detail here.…”

Section: Literature Reviewmentioning

confidence: 99%

Computational Modelling Of Radiofrequency Cardiac Ablation To Study The Effect Of Cooling On Lesion Parameters

Berkmortel¹,

Avari²,

Savory³

2018

Progress in Canadian Mechanical Engineering

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Radiofrequency ablation (RFA) is a technique used to treat cardiac arrhythmias. It creates lesions in the heart by creating thermal damage. Due to limitations associated with in vivo as well as in vitro studies, computational methods assist in further analysis of the problem by allowing for quicker and more diverse parametric studies and hence, a more thorough understanding of the physics involved. These computational models have been proven to be good representations of the process by accurately modelling the catheter with simplified geometry and boundary conditions. Although these studies have inconsistencies in material properties (due to the variation of thermal and mechanical properties in biological tissue) as well as different methods of creating the geometry and applying the boundary conditions, overall they are quite similar. The effects of esophageal cooling were investigated to understand its effect on the process. It was determined that using the standard model found within the literature, the esophageal cooling changed the lesion depth by less than 18%, while changing the maximum tissue temperature by as much as 13.4%.

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“…However, to our knowledge, no previous references have demonstrated any definitive effect on LHER. Previous studies of our group have shown that RF-assisted liver transection could achieve a wide ablation margin (up to 1 cm) without increasing the risk of thermal damage in nearby structures [22,[27][28][29][30]. In this setting, the aim of this study was to determinate whether RF-assisted liver transection reduces local hepatic recurrence over the standard methods especially when this margin was positive.…”

Section: Introductionmentioning

confidence: 97%

The impact of radiofrequency-assisted transection on local hepatic recurrence after resection of colorectal liver metastases

et al. 2017

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Resection is the gold standard in the treatment of liver metastases from colorectal cancer. An internal cooled radiofrequency electrode was described to achieve tissue coagulation to a greater margin width. The aim of this study is to determinate if a RF-assisted transection device (RFAT) has any effect on local hepatic recurrence (LHER) compared to conventional technologies. A study population of 103 patients who had undergone a hepatic surgical resection was retrospectively analysed. Patients were classified into two groups according to the device used: a RF-assisted device (RFAT group; n = 45) and standard conventional devices (control group; n = 58). LHER was defined as any growing or enhancing tumour in the margin of hepatic resection during follow-up. Cox proportional models were constructed and variables were eliminated only if p > 0.20 to protect against residual confounding. To assess the stability of Cox's regression model and its internal validity, a bootstrap investigation was also performed. Baseline and operative characteristics were similar in both groups. With a mean follow-up of 28.5 months (range 2-106), in patients with positive margins, we demonstrated 0% of LHER in RFAT vs. 27% in control group (p = 0.032). In the multivariate analysis five factors demonstrated significant influence on the final model of LHER: RFAT group, size of the largest metastases, number of resected metastases, positive margin and usage of Pringle-manoeuvre. This study suggests that parenchymal transection using a RFAT able to create deep thermal lesions may reduce LHER especially in case of margin invasion during transection.

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Research and development of a new RF-assisted device for bloodless rapid transection of the liver: Computational modeling and in vivo experiments

Cited by 30 publications

References 30 publications

Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF‐assisted surgical resection?

Could the heat sink effect of blood flow inside large vessels protect the vessel wall from thermal damage during RF‐assisted surgical resection?

Computational Modelling Of Radiofrequency Cardiac Ablation To Study The Effect Of Cooling On Lesion Parameters

The impact of radiofrequency-assisted transection on local hepatic recurrence after resection of colorectal liver metastases

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