LCSA is a local charity responding to the needs of those patients with secondary liver cancer whose best chance of lasting cure is surgery together with chemotherapy. To achieve this the LCSA has purchased these pieces of vital diagnostic and surgical equipment. We also fund vital research.
The liver is a very vascular organ and has nearly 30 percent of the body’s blood volume within its substance at any one time. Surgery on the liver was fraught with danger in the past because of the risks of bleeding. With modern understanding of the anatomy of the liver and technological advances, surgery of the liver is now relatively safe.
The CUSA (Cavitron Ultrasonic Surgical Aspirator) incorporates a hand piece, which is the operating instrument, powered by a standalone generator. The vibrating tip of the hand piece fragments the liver cells, thus exposing the blood vessels and bile ducts within the substance of the liver so that these might be tied and divided in an orderly fashion. By this method, anatomical resections of segments of the liver can be carried out safely and with minimal blood loss.
The charity has equipped the Royal Surrey with four CUSA machines and numerous hand pieces.
The charity has bought for the Royal Surrey a SonoSite MicroMaxx ultrasound system with interchangeable handpieces. In addition to standard probes, the charity has bought a laparoscopic probe for use in laparoscopic liver and pancreatic surgery.
This equipment is some years old now and the quality has improved. The charity would be looking to update the equipment and to provide two sets, as there are now four surgeons often operating in parallel.
Microwave ablation is used to destroy liver tumours in patients who are otherwise unfit for surgery. It can also be utilised at surgery for people with extensive disease, when all the liver tumours cannot be removed successfully by surgery.
In the latter scenario, surgery can be used to remove the bulk of the disease and the remnant liver microwave ablation can destroy what remains so that the patient is left with enough functioning liver substance after extensive surgery.
The process involves placing a needle, either percutaneously or at surgery, into the liver tumour and then connecting this to an external generator, which provides the microwave energy.