Skin ligation and argon beam coagulation for giant pachydermatocele resection

Resection of giant neurofibroma in neurofibromatosis type 1 has a high risk of perioperative bleeding because the tumors are enriched in blood vessels, which are weakened due to the loss and thinning of vascular smooth muscle. Therefore, we combined skin ligation around the tumor and use of an argon beam coagulator (ABC) for hemostasis during resecting the giant neurofibroma. The ABC is a non-contact-type hemostasis device employing argon gas as a medium. We examined the usefulness of our method by retrospectively comparing the outcomes of the ABC-use group with those of the non-use group (7 patients, 9 tumors). Although there was no difference in resected tumor weight between the two groups, the operation time was slightly shorter and the volume of blood loss was smaller in ABC-use group than in the non-use group. Our method for hemostasis is easy and safe and is considered to be a useful method.