Despite advances in surgical techniques, achieving hemostasis of the liver, spleen, and bone during major surgery, especially after
trauma, is still difficult. I describe a new procedure my colleagues and I devised to achieve parenchymatous hemostasis using
electrocautery greased with
lidocaine gel. After achieving good results in experimental studies and obtaining approval from our ethics committee, we used
electrocautery greased with
lidocaine gel for hemostasis in the following 36 procedures: multisegmental
hepatectomy to remove hepatic
tumors (n = 6); partial
hepatectomy to allow hepatojejunostomy for intrahepatic biliary obstruction (n = 10); laparoscopic liver biopsy (n = 4); subtotal
splenectomy (n = 8; for
portal hypertension in 5 patients, splenic
ischemia in 2, and
Gaucher's disease in 1); laparoscopic splenic biopsy (n = 1); and bone resection (n = 7; as pelvic-femoral resection in 6 patients and to remove a
rectal tumor invading the coccyx in 1). This procedure was easy to perform and achieved complete hemostasis of the minor blood vessels in all patients. No postoperative
bleeding occurred and the follow-up course was satisfactory.
Electrocautery greased with
lidocaine gel is an inexpensive, readily available, and efficient method to achieve hemostasis of minor vessels in hepatic, splenic, and bone operations.