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. 2017 Jul 8;9(19):840–849. doi: 10.4254/wjh.v9.i19.840

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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

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Illustration of the upper abdomen demonstrating the hydro-dissection technique. A: Coronal colored image shows a hepatic dome lesion very close to the diaphragm; B: Coronal colored image after hydro-dissection (shown in blue color) shows the separation of the dome of liver from the diaphragm which improves percutaneous access to the lesion and limits diaphragmatic injury. White arrow shows the needle for hydodissection and black arrow shows the needle into the lesion. An example of a hepatic dome lesion (C) (arrow) where hydrodissection was attempted by needle placed anteriorly (D) (arrow); E: Axial computed tomography showed accumulation of fluid within the properitoneal fat (arrows); F: The needle was repositioned with the tip of the needle into the peritoneal cavity (arrow); G: Successful hydrodissection achieved using instillation of 500 cc of D5W through the needle (arrow); H: The fluid was used to create a safe path for radiofrequency ablation of the hepatic dome hepatocellular carcinoma. Sagittal Maximum intensity projection image demonstrating the artificial ascites and electrodes in position in the hepatic dome lesion.