Review
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 14, 2007; 13(6): 826-829
Published online Feb 14, 2007. doi: 10.3748/wjg.v13.i6.826
Current role of bloodless liver resection
Spiros G Delis, Juan Madariaga, A Bakoyiannis, Ch Dervenis
Spiros G Delis, A Bakoyiannis, Ch Dervenis, Liver Surgical Unit, A Surgical Clinic, Agia Olga Hospital, Athens, Greece
Juan Madariaga, Department of Surgery, Division of Transplantation & Liver Surgery, University Of Miami School of Medicine, Miami, Florida, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Spiros G Delis MD, PhD, Liver Unit, A Surgical Clinic, Agia Olga Hospital, 3-5 Agias Olgas str., Athens, Greece. sdelis55@hotmail.com
Telephone: +3-210-5012849 Fax: +3-210-5012849
Received: June 29, 2006
Revised: July 1, 2006
Accepted: July 18, 2006
Published online: February 14, 2007
Abstract

Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. Recently new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this article is to address the issue of bloodless liver resection using radiofrequency energy. Radionics, Cool-tipTM System and Tissue Link are some of the devices which are using radiofrequency energy. All information included in this article, refers to these devices in which we have personal experience in our unit of liver surgery. These devices take advantage of its unique combination of radiofrequency current and internal electrode cooling to perform sealing of the small vessels and biliary radicals. Dissection is also feasible with the cool-tip probe. For the purposes of this study patient sex, age, type of disease and type of surgical procedure in association with the duration of parenchymal transection, blood loss, length of hospital stay, morbidity and mortality were analyzed. Cool-tip RF device may provide a unique, simple and rather safe method of bloodless liver resections if used properly. It is indicated mostly in cirrhotic patients with challenging hepatectomies (segment VIII, central resections). The total operative time is eliminated and the average blood loss is significantly decreased. It is important to note that this technique should not be applied near the hilum or the vena cava to avoid damage of these structures.

Keywords: Bloodless liver resection; Radiofrequency; Cool-tip; Tissue link; Hepatectomy