Jet-cutting supported by high frequency current: new technique for hepatic surgery

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Biomedical Engineering

Background:

• Liver resection often involves significant blood loss, necessitating effective hemostatic techniques.
• Current methods like CUSA and conventional jet-cutters separate vessels but lack simultaneous coagulation.
• A novel approach integrating high-frequency current with jet-cutting aims to improve hemostasis during liver resection.

Purpose of the Study:

• To evaluate the efficacy of a novel high-frequency-supported jet-cutting (HF-jet) method for liver resection.
• To compare HF-jet with conventional jet-cutting and CUSA in a rabbit model.
• To assess parameters including resection velocity, blood loss, tissue trauma, selectivity, and physiological effects.

Main Methods:

• Liver resection of the ventral lobe was performed on rabbits using three techniques: conventional jet-cutting, CUSA, and HF-jet.
• Six animals were allocated to each group.
• Key metrics analyzed included resection speed, blood loss, tissue selectivity, histopathology (resectate and 7-day follow-up), electrolytes, and vital signs.

Main Results:

• The HF-jet group demonstrated significantly reduced resection velocity and improved selectivity (fewer isolated vessels per area).
• Histopathological analysis revealed coagulated vessels and a deeper necrotic zone in the HF-jet group.
• Transiently elevated liver enzymes were observed in the HF-jet group; no significant electrolyte or vital sign disturbances were detected.

Conclusions:

• High-frequency-supported jet-cutting is a promising advancement for liver resection, offering simultaneous coagulation.
• This technique may lead to reduced hilum clamping time, decreased blood loss, and fewer blood transfusions in major liver resections.
• The HF-jet method represents a valuable improvement over conventional jet-cutters for liver surgery.