Zacharoulis Dimitris, Lazoura Olga, Sioka Eleni, Tzovaras George, Rountas Christos, Spiropoulos Spiridon, Zahari Eleni, Chatzitheofilou Costas
Department of Surgery, University Hospital of Larissa, Larissa, Greece.
J Laparoendosc Adv Surg Tech A. 2010 Jun;20(5):421-6. doi: 10.1089/lap.2009.0324.
Hemorrhage control in severe splenic and hepatic injuries remains a challenge, despite recent improvements in equipment technology. Radiofrequency (RF) energy-assisted surgery for the spleen and liver has been recently reported; however, the technique has not gained wide acceptance, mainly due to surgeons' unfamiliarity with the technique and the risk of complications caused by uncontrolled disseminated energy. In this study, the safety and efficacy of the Habib 4X (AngioDynamics, Latham, NY), a hand-held bipolar RF energy device, was evaluated in a porcine trauma model.
Five white male Landrace pigs were included in the study. Multiple stab wounds were inflicted to the splenic and hepatic parenchyma, both centrally and peripherally. Hemostasis was achieved by using the Habib 4X RF bipolar device. The pigs were humanely sacrificed 6 weeks postoperatively, and histology of the ablated spleen and liver was evaluated.
Hemorrhage was successfully controlled at all bleeding sites, using appropriate RF generator settings. The splenic artery and vein, as well as the hepatic veins, were successfully ligated using the device. No complications were noted immediately postoperatively or 6 weeks following the procedure.
The bipolar Habib 4X device delivers RF energy that can achieve hemostasis of the injured splenic and hepatic parenchyma. The method is feasible and safe. Clinical studies are warranted to assess short- and long-term results of this promising technique and compare it to the gold standards.
尽管设备技术最近有所改进，但严重脾损伤和肝损伤的出血控制仍然是一项挑战。最近有报道称可采用射频（RF）能量辅助进行脾脏和肝脏手术；然而，该技术尚未得到广泛认可，主要原因是外科医生对该技术不熟悉，以及存在因能量扩散失控而导致并发症的风险。在本研究中，在猪创伤模型中评估了手持式双极射频能量设备Habib 4X（AngioDynamics，纽约州拉瑟姆）的安全性和有效性。
本研究纳入了5只白色雄性长白猪。在脾脏和肝脏实质的中央和周边造成多处刺伤。使用Habib 4X射频双极设备实现止血。术后6周对猪实施安乐死，并对切除的脾脏和肝脏进行组织学评估。
使用适当的射频发生器设置，所有出血部位的出血均成功得到控制。使用该设备成功结扎了脾动脉和静脉以及肝静脉。术后即刻及术后6周均未发现并发症。
双极Habib 4X设备可传递射频能量，能够实现对受损脾脏和肝脏实质的止血。该方法可行且安全。有必要开展临床研究以评估这项有前景的技术的短期和长期效果，并将其与金标准进行比较。
