Paolucci, Iwan; Schwalbe, Marius; Prevost, Gian Andrea; Lachenmayer, Anja; Candinas, Daniel; Weber, Stefan; Tinguely, Pascale Marie Pia (18 May 2018). Intraoperative ultrasound based navigation for laparoscopic ablation of liver tumors. British journal of surgery, 105(Suppl3), p. 21. John Wright & Sons
Objective: We evaluated a navigation technique for laparoscopic ablation
of malignant liver lesions that relies on intraoperative ultrasound only, thus
reduces additional efforts and inaccuracies by not incorporating calibration and
registration processes compared to other techniques.
Methods: The target tumor was selected on an electromagnetically (EM)
tracked ultrasound image and the ablation probe placed into the target using
an EM tracked trocar. After the placement, a 3D ultrasound image was used
for validation of the probe position and measurement of the target positioning
error (TPE). Three surgeons performed 10 ablation probe placements using
the navigated approach and the non-navigated (conventional) approach in a
laparoscopic model. We compared the number of probe repositionings, TPE,
and time for targeting.
Results: Overall, 60 targetings were performed using the navigated and the
non-navigated approach (n = 30 each). In the navigated targetings no probe
repositionings were needed, whereas in 17 of the 30 (59%) non-navigated
targetings the probe had to be repositioned to hit the tumor. The median TPE
was 4.2 mm (IQR 2.9-5.3 mm) versus 6 mm (IQR 4.7-7.5 mm) and the median
time for targeting was 39 seconds (IQR 24-47 seconds) versus 76 seconds (IQR
47-121 seconds) for the navigated and non-navigated approach respectively
(p < 0.01 each).
Conclusion: This tumor-targeted navigation approach was shown to be
user-friendly and allowed for more accurate and efcient targeting of liver
tumors in a laparoscopic model. By not requiring a registration nor a calibration process it might represent a simple and efficient alternative to registration
based navigation methods.
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