Open Hepatic Transection Using Microwave Tissue Coagulation

  • Sohei SatoiEmail author
  • Hiroaki Kitade
  • Yoichi Matsui
  • A-Hon Kwon


In surgical treatment of liver tumors, it is important to consider the balance between the liver volume to be resected and the liver functional reserve. The technique of microwave tissue coagulation (MTC) has been applied clinically for transection of hepatic parenchyma with or without underlying liver cirrhosis. Use of MTC has been reported to reduce blood loss and to enable nonanatomical liver resection, even in patients with poor liver functional reserve. This type of hepatic transection is easy to perform and does not require special surgical techniques. In this chapter, we describe the MTC device, surgical indications, and surgical technique, illustrated with photographs and video on the use of MTC for open hepatic transection.


Hepatic transection  Microwave tissue coagulation  Surgical technique  Nonanatomical liver resection  

Supplementary material

ESM 1 (VIDEO 50.0 MB)


  1. 1.
    Jarnagin WR, Gonen M, Fong Y et al. (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–406PubMedCrossRefGoogle Scholar
  2. 2.
    Pringle JH (1908) Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg 48:541–549PubMedCrossRefGoogle Scholar
  3. 3.
    Rahbari NN, Koch M, Zimmermann JB, Elbers H et al. (2011) Infrahepatic inferior vena cava clamping for reduction of central venous pressure and blood loss during hepatic resection: a randomized controlled trial. Ann Surg 253:1102–1110PubMedCrossRefGoogle Scholar
  4. 4.
    Takayama T, Makuuchi M, Kubota K et al. (2001) Randomized comparison of ultrasonic vs clamp transection of the liver. Arch Surg 136:922–928PubMedCrossRefGoogle Scholar
  5. 5.
    Papachristou DN, Barters R (1982) Resection of the liver with a water jet. Br J Surg 69:93–94PubMedCrossRefGoogle Scholar
  6. 6.
    Schmidbauer S, Hallfeldt KK, Sitzmann G et al. (2002) Experience with ultrasound scissors and blades (UltraCision) in open and laparoscopic liver resection. Ann Surg 235:27–30PubMedCrossRefGoogle Scholar
  7. 7.
    Tabuse K, Katsumi M, Kobayashi Y et al. (1985) Microwave surgery: hepatectomy using a microwave tissue coagulator. World J Surg 9:136–143PubMedCrossRefGoogle Scholar
  8. 8.
    Ryu M, Watanabe K, Yamamoto H (1998) Hepatectomy with microwave tissue coagulation for hepatocellular carcinoma. J Hep Bil Pancr Surg 5:184–191CrossRefGoogle Scholar
  9. 9.
    Satoi S, Kamiyama Y, Matsui Y et al. (2005) Clinical outcome of 214 liver resections using microwave tissue coagulation. Hepatogastroenterology 52:1180–1185PubMedGoogle Scholar
  10. 10.
    Satoi S, Matsui Y, Kitade H et al. (2008) Long-term outcome of hepatocellular carcinoma patients who underwent liver resection using microwave tissue coagulation. HPB 10:289–295PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Matsui Y, Terakawa N, Satoi S et al. (2007) Postoperative outcomes in patients with hepatocellular carcinomas resected with exposure of the tumor surface clinical role of the no-margin resection. Arch Surg 142:596–602PubMedCrossRefGoogle Scholar
  12. 12.
    Tabuse K (1998) Basic knowledge of a microwave tissue coagulator and its clinical applications. J Hepatobiliary Pancreat Surg 5:165–172PubMedCrossRefGoogle Scholar
  13. 13.
    Eguchi S, Kanematsu T, Arii S et al. (2008) Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery 143:469–475PubMedCrossRefGoogle Scholar
  14. 14.
    Kanematsu T, Takenaka K, Matsumata T et al. (1984) Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg 199:51–56PubMedCrossRefGoogle Scholar
  15. 15.
    Regimbeau JM, Kianmanesh R, Farges O et al. (2002) Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery 131:311–317PubMedCrossRefGoogle Scholar
  16. 16.
    Hasegawa K, Kokudo N, Imamura H et al. (2005) Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg 242(2):252–259PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Sohei Satoi
    • 1
    Email author
  • Hiroaki Kitade
    • 1
  • Yoichi Matsui
    • 1
  • A-Hon Kwon
    • 1
  1. 1.SurgeryKansai Medical UniversityHirakata, OsakaJapan

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