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NEAR-BLOODLESS LAPAROSCOPIC LIVER RESECTION USING MICROWAVE PRE-PLANE ABLATION IN CIRRHOTIC PATIENTS

Morgan M Bonds, MD, Janelle Rekman, MD, George Baison, MD, Adnan Alseidi, MD. Virginia Mason Medical Center

Resection of hepatic malignancies in cirrhotic patients present a unique challenge to surgeons. Due to the need to preserve liver parenchyma in these cases, non-anatomic resection with close surgical margins is the procedure of choice. This technique can lead to increased blood loss which is exacerbated in cirrhotic patients with portal hypertension. These challenges are more arduous when attempting laparoscopic resection. In this video, we present microwave pre-plane ablation as a technique to achieve hemostasis prior to liver parenchymal transection. Microwave pre-plane ablation is demonstrated in two cases. In both instances, the tumors were successfully resected with less than 50cc of estimated blood loss and the patients were discharged within 36 hours. The video is a cognitive task analysis modular video that includes tips for success and pitfalls when performing microwave pre-plane ablation and parenchymal transection during laparoscopic liver resection in patients with cirrhosis.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94246

Program Number: V328

Presentation Session: Video Loop Day 3

Presentation Type: VideoLoop

49

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