In this study the effect of hepatic blood perfusion on lesion size, produced with Nd:YAG interstitial laser coagulation (ILC) was investigated. In 10 pigs the liver was exposed at a thoracolaparotomy. Lesions (n equals 23) were created with 4 cylindrical diffusing (2 cm length) fibers applied simultaneously (5 W per fiber, 6 min). There were three experimental groups: (1) with flow through the liver, (2) with portal vein clamped, and (3) with both hepatic artery and portal vein clamped. Immediately after sacrifice, the liver was dissected for macroscopic and microscopic assessment. The coagulated volume with flow (mean 6.5 cm3) was considerably smaller than with partial flow (30.6 cm3) and non flow (26.6 cm3). No significant difference was found in coagulated volume between the partial flow and non flow condition. Fusion of the coagulation zones surrounding the fibers was always found under partial flow and nonflow condition whereas this was never the case under the flow condition. This study shows the importance of occluding the portal flow during ILC.

, , , , , , ,
doi.org/10.1117/12.275088, hdl.handle.net/1765/56293
Department of Surgery

van Hillegersberg, R., Heisterkamp, J., Sinofsky, E., Mulder, P., & IJzermans, J. (1997). Increasing lesion size in interstitial laser coagulation: The importance of eliminating hepatic perfusion. doi:10.1117/12.275088