JET-CUTTING SUPPORTED BY HIGH-FREQUENCY CURRENT - NEW TECHNIQUE FOR HEPATIC SURGERY

To reduce blood loss incurred during liver resection, techniques that separate vessels from Liver parenchyma, such as the CUSA or the jet-cu tter, are in clinical use. By conducting high frequency current throug h the jet beam using hypertonic NaCl cutting solution, we developed a new method enabling simultaneous coagulation during selective cutting. In this study we examined the effects of this method on liver resecti on in a rabbit model. With the three techniques-jet-cutting, CUSA, and high frequency-supported jet-cutting (HF-jet) -we performed liver res ection of the ventral Lobe in six animals per group. We compared veloc ity of resection, blood loss, tissue trauma, selectivity (number of is olated vessels per area), electrolytes, and vital signs. Histopatholog y was carried out with the resectate and after 7 days with the remaini ng liver. Velocity of resection procedure and selectivity were signifi cantly reduced in the RF-jet group. Histopathology showed coagulated v essels and a deeper zone of necrosis. Accordingly, the liver enzymes t ransiently showed distinctly higher values in the HF-jet group. Electr olyte disturbances or differences of vital signs could not be detected . Transferring our results to patient tare we expect that with major r esections the hilus clamping time, blood loss, and number of blood tra nsfusions can be reduced. In our opinion the additional application of high frequency through the jet beam is a helpful improvement of the j et-cutter.