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Hemostasis Plug for an Electromagnetic Thermotherapy and Its Application for Liver Laceration

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Abstract

Accident-induced liver trauma is a significant human health concern, as this organ is readily injured during periods at which the abdominal region is compromised. In this work, electromagnetic thermotherapy was successfully developed and employed in vitro and in vivo to treat livers that had been lacerated. Briefly, a new hemostasis plug was integrated with an electromagnetic thermotherapy system (ETS) to perform surgery on lacerated livers. The high-frequency, alternating electromagnetic field (EMF) was generated by the ETS and was shown to induce a pre-set temperature increase within the hemostasis plug embedded in the target tissue. In order to prevent overheating and maintain a constant hemostasis temperature, a temperature feedback control system was utilized. The effect of the intensity of the EMF on the heating capacity of the ETS-hemostasis system was first explored. Furthermore, the relationship between the coagulation zone and operating temperature were investigated in vitro. By utilizing the temperature feedback control system, the hemostasis plug could be heated to a specific temperature for efficient hemostasis. With this approach, the optimal treatment temperature and time were investigated for liver laceration. Lacerated livers from New Zealand white rabbits were successfully treated with the hemostasis plug and ETS within a short period of time. When compared with the traditional perihepatic packing approach, the volume of blood loss from liver laceration surgeries treated by ETS has been dramatically reduced by 83%, suggesting a high therapeutic potential for this system.

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References

  1. Abdalla, E. K., J. N. Vauthey, L. M. Ellis, V. Ellis, R. Pollock, K. R. Broglio, K. Hess, and S. A. Curley. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann. Surg. 239(6):818–827, 2004.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Caruso, D. M., F. D. Battistella, J. T. Owings, S. L. Lee, and R. C. Samaco. Perihepatic packing of major liver injuries: complications and mortality. Arch. Surg. 134(9):958–963, 1999.

    Article  CAS  PubMed  Google Scholar 

  3. Chen, C. Y., R. Zuchini, H. W. Tsai, C. H. Huang, S. C. Huang, G. B. Lee, and X. Z. Lin. Electromagnetic thermal surgery system for liver resection: an animal study. Int. J. Hyperth. 26(6):604–609, 2010.

    Article  CAS  Google Scholar 

  4. Clancy, T. V., J. Gary-Maxwell, D. L. Covington, C. C. Brinker, and D. A. Blackman. A statewide analysis of level I and II trauma centers for patients with major injuries. J. Trauma 51(2):346–351, 2001.

    Article  CAS  PubMed  Google Scholar 

  5. Demetriades, D., H. Gomez, S. Chahwan, K. Charalambides, G. Velmahos, and J. Murray. Gunshot injuries to the liver: the role of selective nonoperative management. J. Am. Coll. Surg. 188(4):343–348, 1999.

    Article  CAS  PubMed  Google Scholar 

  6. Demetriades, D., P. Hadjizacharia, C. Constantinou, C. Brown, K. Inaba, and P. Rhee. Selective nonoperative management of penetrating abdominal solid organ injuries. Ann. Surg. 244(4):620–628, 2006.

    PubMed  PubMed Central  Google Scholar 

  7. Flanagan, T. B., B. S. Bowerman, and G. E. Biehl. Hysteresis in metal/hydrogen systems. Scr. Mater. 14(4):443–447, 1980.

    CAS  Google Scholar 

  8. Harold, B. G., C. N. Hoyler, and R. A. Bierwirth. Theory and application of radio-frequency heating. New York: D. Van Nostrand Company Inc., 1947.

    Google Scholar 

  9. Huang, S. C., Y. Y. Chang, Y. J. Chao, Y. S. Shan, X. Z. Lin, and G. B. Lee. Dual-row needle arrays under an electromagnetic thermotherapy system for bloodless liver resection surgery. IEEE Trans. Biomed. Eng. 59(3):824–831, 2012.

    Article  PubMed  Google Scholar 

  10. Jais, P., M. Haissaguerre, D. C. Shah, S. Chouairi, L. Gencel, M. Hocini, and J. Clementy. A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation 95(3):572–576, 1997.

    Article  CAS  PubMed  Google Scholar 

  11. Lin, T. Y. A Simplified Technique for Hepatic Resection: The Crush Method. Ann. Surg. 180(3):285–290, 1974.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Madding, G. F., and W. H. Peniston. Liver hemostasis. Surg. Gynecol. Obstet. 104(5):417–424, 1957.

    CAS  PubMed  Google Scholar 

  13. Matthes, G., D. Stengel, J. Seifert, G. Rademacher, S. Mutze, and A. Ekkernkamp. Blunt liver injuries in polytrauma: results from a cohort study with the regular use of whole body helical computed tomography. World J. Surg. 27(10):1124–1130, 2003.

    Article  PubMed  Google Scholar 

  14. McGahan, J. P., and G. D. Dodd. Radiofrequency ablation of the liver. Am. J. Roentgenol. 176(1):3–16, 2001.

    Article  Google Scholar 

  15. Millikan, J. S., E. E. Moore, G. E. Moore, and R. E. Stevens. Alternatives to splenectomy in adults after trauma: repair, partial resection, and reimplantation of splenic tissue. Am. J. Roentgenol. 144(6):711–716, 1982.

    CAS  Google Scholar 

  16. Patterson, E. J., C. H. Scudamore, D. A. Owen, A. G. Nagy, and A. K. Buczkowski. Radiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size. Ann. Surg. 227(4):559–565, 1998.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Saifi, J., J. B. Fortune, L. Graca, and D. M. Shah. Benefits of intra-abdominal pack placement for the management of nonmechanical hemorrhage. Arch. Surg. 125(1):119–122, 1990.

    Article  CAS  PubMed  Google Scholar 

  18. Shan, Y. S., R. Zuchini, H. W. Tsai, P. W. Lin, G. B. Lee, and X. Z. Lin. Bloodless liver resection using needle arrays under alternating electromagnetic fields. Surg. Innov. 17(2):95–100, 2010.

    Article  PubMed  Google Scholar 

  19. Van, Z. J. Heating the patient: a promising approach? Ann. Oncol. 13(8):1173–1184, 2002.

    Article  Google Scholar 

  20. Voutsalath, M. A., C. K. Bichakjian, F. Pelosi, D. Blum, T. M. Johnson, and P. M. Farrehi. Electrosurgery and implantable electronic devices: review and implications for office-based procedures. Dermatol. Surg. 37(7):889–899, 2011.

    Article  CAS  PubMed  Google Scholar 

  21. Walt, A. J. The mythology of liver trauma, or Babel revisited. Am. J. Surg. 135(1):12–18, 1978.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the Southern Taiwan Science Park, Ministry of Science and Technology, Taiwan (STSP 102CP01) for partial financial support of this project. The authors would also like to thank Shuen-Fong Chen, Kuan-Cheng Chen and Chi-Ming Ho for assisting with the liver laceration surgery on animal models.

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Authors and Affiliations

  1. Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, 300, Taiwan

    Chung-Hsien Liu, Sheng-Chieh Huang & Gwo-Bin Lee

  2. Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, 300, Taiwan

    Gwo-Bin Lee

  3. Institute of NanoEngineering and Microsystems, National Tsing Hua University, Hsinchu, 300, Taiwan

    Gwo-Bin Lee

  4. Department of Surgery, National Cheng Kung University, Tainan, 701, Taiwan

    Ying-Jui Chao

  5. Department of Internal Medicine, National Cheng Kung University, Tainan, 701, Taiwan

    Xi-Zhang Lin

Authors
  1. Chung-Hsien Liu
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  2. Sheng-Chieh Huang
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  3. Ying-Jui Chao
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  4. Xi-Zhang Lin
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  5. Gwo-Bin Lee
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Corresponding authors

Correspondence to Xi-Zhang Lin or Gwo-Bin Lee.

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Associate Editor Jennifer West oversaw the review of this article.

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Liu, CH., Huang, SC., Chao, YJ. et al. Hemostasis Plug for an Electromagnetic Thermotherapy and Its Application for Liver Laceration. Ann Biomed Eng 44, 1310–1320 (2016). https://doi.org/10.1007/s10439-015-1365-9

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  • DOI: https://doi.org/10.1007/s10439-015-1365-9

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