Use of radiofrequency hepatic parenchymal transection device in hepatic hemangioma resection: early experience and lessons learned.

Abstract

BACKGROUND: Control of intraoperative hemorrhage represents a significant challenge in hepatic surgery, particularly during resection of large, hypervascular hepatic hemangiomata (HH). Various devices to minimize blood loss from hepatic parenchymal transection are currently under investigation. Herein, we present our experience with a radiofrequency (RF)-powered multiarray for resection of HH. PATIENTS AND METHODS: From September 2005 to January 2006, we conducted a retrospective review of our hepatobiliary database to identify patients with symptomatic giant cavernous HH undergoing resection with a RF multiarray device. The purpose of this review was to assess the technical aspects of using RF energy to assist in the resection of HH. RESULTS: The extent of operation varied depending on the size and location of the tumor. Two patients underwent two atypical subsectionectomies and two underwent trisectionectomies. The Habib sealer provided a safe and effective method for hepatic parenchymal transaction. No patients required blood transfusion, and no injuries to major biliary or vascular strictures were observed at 1 year follow-up. A seroma developed in one patient 6 months postoperatively, but was drained percutaneously. CONCLUSIONS: Hepatic parenchymal transection with the Habib sealer device is a feasible approach to resect HH. Further study is needed to objectively compare the efficacy of RF-assisted parenchymal transection with that of traditional parenchymal transection techniques.

AI evidence extraction

Main findings

In a retrospective review of four hepatic hemangioma resections using an RF-powered multiarray (Habib sealer), no patients required blood transfusion and no injuries to major biliary or vascular structures/strictures were observed at 1-year follow-up. One patient developed a seroma at 6 months that was drained percutaneously.

Outcomes measured

• Intraoperative hemorrhage/blood loss (proxy: need for transfusion)
• Blood transfusion requirement
• Injuries to major biliary or vascular structures/strictures
• Postoperative complications (seroma)
• Feasibility/safety of RF-assisted hepatic parenchymal transection

Limitations

• Retrospective review
• Very small sample size (n=4)
• No control/comparator group
• Short/limited follow-up reporting (1 year mentioned)
• Efficacy not objectively compared with traditional transection techniques

Suggested hubs

• engineering (0.55)
  Use of radiofrequency-powered surgical device for tissue transection/sealing rather than environmental EMF exposure.

{
    "study_type": "other",
    "exposure": {
        "band": null,
        "source": "radiofrequency surgical device (Habib sealer)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients with symptomatic giant cavernous hepatic hemangioma undergoing hepatic resection",
    "sample_size": 4,
    "outcomes": [
        "Intraoperative hemorrhage/blood loss (proxy: need for transfusion)",
        "Blood transfusion requirement",
        "Injuries to major biliary or vascular structures/strictures",
        "Postoperative complications (seroma)",
        "Feasibility/safety of RF-assisted hepatic parenchymal transection"
    ],
    "main_findings": "In a retrospective review of four hepatic hemangioma resections using an RF-powered multiarray (Habib sealer), no patients required blood transfusion and no injuries to major biliary or vascular structures/strictures were observed at 1-year follow-up. One patient developed a seroma at 6 months that was drained percutaneously.",
    "effect_direction": "unclear",
    "limitations": [
        "Retrospective review",
        "Very small sample size (n=4)",
        "No control/comparator group",
        "Short/limited follow-up reporting (1 year mentioned)",
        "Efficacy not objectively compared with traditional transection techniques"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency",
        "Habib sealer",
        "hepatic parenchymal transection",
        "hepatic hemangioma",
        "hepatic resection",
        "blood loss",
        "transfusion",
        "surgical device"
    ],
    "suggested_hubs": [
        {
            "slug": "engineering",
            "weight": 0.5500000000000000444089209850062616169452667236328125,
            "reason": "Use of radiofrequency-powered surgical device for tissue transection/sealing rather than environmental EMF exposure."
        }
    ]
}

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