RESEARCH ARTICLE
An Electrode Array for Limiting Blood Loss During Liver Resection: Optimization via Mathematical Modeling
R.M Strigel1, D.J Schutt2, J.G. Webster3, D.M Mahvi4, D Haemmerich*, 2, 5
Article Information
Identifiers and Pagination:
Year: 2010Volume: 4
First Page: 39
Last Page: 46
Publisher ID: TOBEJ-4-39
DOI: 10.2174/1874120701004020039
Article History:
Received Date: 3/9/2009Revision Received Date: 10/11/2009
Acceptance Date: 20/12/2009
Electronic publication date: 4/2/2010
Collection year: 2010
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Abstract
Liver resection is the current standard treatment for patients with both primary and metastatic liver cancer. The principal causes of morbidity and mortality after liver resection are related to blood loss (typically between 0.5 and 1 L), especially in cases where transfusion is required. Blood transfusions have been correlated with decreased long-term survival, increased risk of perioperative mortality and complications. The goal of this study was to evaluate different designs of a radiofrequency (RF) electrode array for use during liver resection. The purpose of this electrode array is to coagulate a slice of tissue including large vessels before resecting along that plane, thereby significantly reducing blood loss. Finite Element Method models were created to evaluate monopolar and bipolar power application, needle and blade shaped electrodes, as well as different electrode distances. Electric current density, temperature distribution, and coagulation zone sizes were measured. The best performance was achieved with a design of blade shaped electrodes (5 × 0.1 mm cross section) spaced 1.5 cm apart. The electrodes have power applied in bipolar mode to two adjacent electrodes, then switched sequentially in short intervals between electrode pairs to rapidly heat the tissue slice. This device produces a ~1.5 cm wide coagulation zone, with temperatures over 97 ºC throughout the tissue slice within 3 min, and may facilitate coagulation of large vessels.
