Assisted hepatic resection using a toroidal HIFU device: an in vivo comparative study in pig

Area of Science:

• Hepatobiliary surgery
• Minimally invasive surgical techniques
• Oncology

Background:

• Postoperative bleeding is a major complication in hepatic surgery.
• Blood loss and transfusions are linked to increased tumor recurrence in colorectal liver metastases.
• High-intensity focused ultrasound (HIFU) offers a novel approach for liver tumor treatment.

Purpose of the Study:

• To evaluate the efficacy of a novel HIFU device in minimizing blood loss and dissection time during liver resection in an animal model.
• To compare HIFU-assisted liver resection with traditional methods (clamping and no clamping).

Main Methods:

• A HIFU device with a toroidal-shaped transducer was used to create coagulative necrosis before liver transection.
• Partial liver resections were performed in pigs, comparing HIFU assistance with intermittent Pringle maneuver (IPM) and control groups.
• Blood loss per dissection surface area and resection time were the primary outcome measures.

Main Results:

• HIFU-assisted resection showed a trend towards lower blood loss compared to IPM (p=0.09) and significantly reduced blood loss versus the control group (p=0.03).
• Resection time was significantly shorter with HIFU (13 min) compared to IPM (23 min) and control (18 min) groups (p<0.01).
• HIFU precoagulation sealed vessels <5mm, significantly reducing the need for surgical clips.

Conclusions:

• HIFU-assisted liver resection is a promising technique for reducing intraoperative bleeding and operative time.
• This method demonstrates potential for improved clinical application in liver metastasis resection.