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The research results of the new method of bloodless resection of parenchymal tissue

Keywords:

G.G. Akhaladze - Dr.Sc.(Med.), Professor, Chief Research Scientist, Department of Surgery and Surgical Technologies in Oncology, Russian Scientific Center of Rentgenoradiology, Moscow. E-mail: gur371ax@gmail.com E.N. Grebenkin - Ph. Dr. (Med.), Research, Scientist, Department of Surgery and Surgical Technologies in Oncology, Russian Scientific Center of Rentgenoradiology. E-mail genbytu@mail.ru V.N. Makarov - Dr.Sc. (Phys.-Math.), Professor, Department of Biomedical Electronics, Moscow State University of Information Technologies, Radioengineering and Electronics. E-mail: makarov_vn@bk.ru G.V. Yushchenko - Technical Director, Company «TECHNOSVET», Moscow. E-mail: geoyushchenko@gmail.com


Stopping the bleeding from parenchymal organs (liver, kidney) during surgery is a complex and far from solving problems. Currently to stop bleeding in liver resections various methods, which in principle can be divided into two groups. The first group includes methods to stop bleeding by clotting blood vessels with subsequent or simultaneous liver resection. The second group comprises methods for temporarily stopping blood flow in the liver cutting by compression of lead vessels. Features of the bloodless resection can be realized by combining these two methods. The effect of «infusion» of blood vessels without isolation of parenchymal tissue is achieved automatically by the coagulation of the vessel wall with the surrounding tissues. An experimental setup has been completed on the basis of complex «METATOM-2», comprising a high-frequency generator and a supply system to the saline clamp jaws. The design clip gives a possibility to carry tissue coagulation followed by resection and resection is performed on the already formed collagen comprising tissue with blood vessels. Using the described method of dissection at the Russian Scientific Center of Radiology in 13 patients were performed hepatic resection of various sizes. The average amount of blood loss during resection using this method was 703,9 ± 638,9 ml. The average duration of the intervention was 282,7 ± 109,5 minutes. For comparison the average amount of blood loss in the group of 27 patients using the harmonic scalpel was 2302,9 ± 1544,1 ml. which was significantly greater than the volume of blood loss in the group studied the method (p = 0,003). The average duration of the intervention was 333,2 ± 97,3 minutes. It is much higher but significant differences are not received (p = 0,1). Thus the tests have shown the ability to work effectively for complex radio frequency ablation of biological tissue during operations on parenchymal organs. There was a significant decline in blood loss during resection. Pronounced downward trend in the duration of the operation is observed.
References:

 

  1. Patjutko JU.I., Sagajjdak I.V., Kotelnikov A.G.i dr.Rezekcija pecheni: sovremennye tekhnologii pri opukholevom porazhenii // Annaly khirurgicheskojj gepatologii. 2010. T. 15. № 2. S. 9–17.
  2. A.s. № 1366153. Mikrovolnovyjj skalpel / V.N. Makarov, V.A. Nedelko, JU.A. KHitrov.
  3. Patent № 139710 (RF). Bipoljarnyjj ehlektrod dlja razrushenija biotkani / V.N. Makarov, M.A. Makhov, S.M. Makarova. 2014.
  4. Ashrafov A.A., Bajjramov N.JU., Melikova M.D.Sovremennye metody rassechenija parenkhimy pecheni. Obzor literatury // Annaly khirurgicheskojj gepatologii. 2000. T. 5. № 2. S. 54–61.

 


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