Laparoscopic ablation of liver adenoma by radiofrequency electrocauthery.

Two percutaneous and minimally invasive means of ablating small hepatocellular carcinomas (HCC) are (1) injection of ethanol guided by ultrasonography (US),1 and (2) interstitial hyperthermia induced by an electrode needle activated by radiofrequency (RF) or by insertion of a laser fiber, also under US guidance. 2, 3 The extent of necrosis induced by interstitial hyperthermia is exactly predictable. The size of the thermally induced lesion depends on the needle size, the temperature of the needle tip, and the e xposure time (however, exposure in excess of 120 seconds does not cause a further increase in the volume of necrosis). Keeping the tip temperature below 100 ° C at hottest focus within t he lesion will avoid boiling or sticking and the associated risks. 4, 5 The use of interstitial RF hyperthermia is similar to that employed in neurosurgery. 5 An RF electrode needle or laser fiber also may be inserted in the course of laparoscopy. A recent report described laser-assisted excision of a liver cyst using a laparoscopic approach. 6 We report here a case of adenoma, superficially located in the liver, treated by laparoscopically guided RF interstitial hyperthermia.