Laparoscopic ablation of liver adenoma by radiofrequency electrocauthery.

Two percu taneous and min imal ly invasive means of abla t ing small hepatoce l lu lar carc inomas (HCC) are (1) injection of e thanol guided by u l t r asonography (US),1 and (2) inters t i t ia l h y p e r t h e r m i a induced by an electrode needle ac t iva ted by rad iof requency (RF) or by inser t ion of a laser fiber, also unde r US guidance. 2, 3 The ex ten t of necrosis induced by inters t i t ia l hyp e r t h e r m i a is exact ly predic table . T h e size o f the the rmal ly induced lesion depends on the needle size, the t e m p e r a t u r e of the needle t ip, and the exposure t ime (however, exposure in excess of 120 seconds does not cause a fu r the r increase in the volume of necrosis). Keep ing the t ip t e m p e r a t u r e below 100 ° C at ho t t es t focus wi thin the lesion will avoid boiling or st icking and the associated risks. 4, 5 T h e use of inters t i t ia l RF h y p e r t h e r m i a is s imilar to t h a t employed in neurosurgery. 5 An RF electrode needle or laser fiber also m a y be inser ted in the course of laparoscopy. A recent r epor t descr ibed laser-assis ted excision of a liver cyst using a laparoscopic approach. 6 We repor t here a case of adenoma, superficially loca ted in the liver, t r ea t ed by laparoscopical ly guided RF inters t i t ia l hyper the rmia .