Jefferson Specialists Perform High Tech Surgery to Safely Remove up to 75 Percent of Cancerous Livers
Transplant
surgeons at Thomas Jefferson University Hospital in Philadelphia are
using a new method called “bloodless” liver resection to safely remove
up to 75 percent of the largest organ in the human body. The technique
is improving patients’ odds and cutting recovery time in half.
Cataldo
Doria, M.D., Ph.D., director of the Division of Transplantation at
Jefferson, and associate professor of Surgery at Jefferson Medical
College, has performed hundreds of liver procedures. But Dr. Doria’s
two newest surgical tools are making a remarkable difference for
patients with localized liver cancer and other liver diseases because
they enable the extraction of cancer tissue while preventing blood
loss.
“Patients
are having such a speedy recovery because there is next to no blood
loss with this new procedure,” says Dr. Doria, who helped to develop
the technique. “That’s why we call it ‘bloodless’. Our goal is to
eliminate the need for transfusion.”
The
number of Americans diagnosed with liver cancer has doubled in the last
decade, with new cases of primary liver cancer continuing to increase.
According to the American Liver Foundation, over 80 percent of primary
liver cancer cases in the U.S. are linked to cirrhosis, or scarring, of
the liver, which is predominantly caused by hepatitis C (HCV),
hepatitis B (HBV) and alcohol abuse. Chronic infection with HBV
(without cirrhosis) and obesity are the two other leading risk factors
for liver cancer.
Surgical
resection is generally the best treatment option for patients with
localized liver cancer. However, the liver receives blood from two
major sources—a large vein coming from the intestines and a large
artery—which makes it challenging for any surgeon to make incisions
using traditional methods. When they do, a patient may need as many as
five to 10 units of blood or more. But the new “bloodless” resection
technique has changed all of that.
Explains
Dr. Doria, “The liver is similar to a sponge full of blood, and cutting
it in the traditional sense is complex because major bleeding can
occur. With this new method there is no cutting. We are able to suck
out the liver’s cells and seal off the blood vessels immediately.”
Instead
of using a scalpel, Dr. Doria is now using a device called a
cavitational ultrasonic surgical aspirator, or CUSA, which uses
ultrasonic waves to aspirate (suction out) liver cells, leaving behind
only a skeleton of blood vessels. Another surgeon follows Dr. Doria
with a second tool called a TissueLink. This probe streams hot,
sterile water from its tip to coagulate the liver’s blood vessels,
sealing them upon contact. Combining these tools reduces surgical time
by nearly half (only two to four hours with the “bloodless” method,
contrasted with the four to six hours of a traditional resection). The
technique also confines any tissue damage to a much smaller area than
if a scalpel had been used.
With
the new “bloodless” liver resection, patients are generally up and
walking 24 hours after surgery, remain in the hospital only five to
seven days (compared with 10 to 14), are back to regular activities in
two weeks (as opposed to four ) and completely recovered in one month.
Up to 75 percent of a patient’s liver can be removed safely with this
technique. The resected liver can regenerate to its original size in
two to three weeks.
Media Only Contact:
Ed Federico
Thomas Jefferson University Hospital
Phone: (215) 955-6300
Published: 1/15/2008