Laparoscopic image-based navigation for microwave ablation of liver tumors – A multi-center study

Tinguely, Pascale Marie-Pia; Fusaglia, Matteo; Freedman, Jacob; Banz Wüthrich, Vanessa; Weber, Stefan; Candinas, Daniel; Nilsson, Henrik (2017). Laparoscopic image-based navigation for microwave ablation of liver tumors – A multi-center study. Surgical endoscopy, 31(10), pp. 4315-4324. Springer 10.1007/s00464-017-5458-4

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BACKGROUND Stereotactic navigation technology has been proposed to augment accuracy in targeting intrahepatic lesions for local ablation therapy. This retrospective study evaluated accuracy, efficacy, and safety when using laparoscopic image-guided microwave ablation (LIMA) for malignant liver tumors. METHODS All patients treated for malignant liver lesions using LIMA at two European centers between 2013 and 2015 were included for analysis. A landmark-based registration technique was applied for intraoperative tumor localization and positioning of ablation probes. Intraoperative efficiency of the procedure was measured as number of registration attempts and time needed to achieve sufficient registration accuracy. Technical accuracy was assessed as Fiducial Registration Error (FRE). Outcome at 90 days including mortality, postoperative morbidity, rates of incomplete ablations, and early intrahepatic recurrences were reported. RESULTS In 34 months, 54 interventions were performed comprising a total of 346 lesions (median lesions per patient 3 (1-25)). Eleven patients had concomitant laparoscopic resections of the liver or the colorectal primary tumor. Median time for registration was 4:38 min (0:26-19:34). Average FRE was 8.1 ± 2.8 mm. Follow-up at 90 days showed one death, 24% grade I/II, and 4% grade IIIa complications. Median length of hospital stay was 2 days (1-11). Early local recurrence was 9% per lesion and 32% per patient. Of these, 63% were successfully re-ablated within 6 months. CONCLUSIONS LIMA does not interfere with the intraoperative workflow and results in low complication and early local recurrence rates, even when simultaneously targeting multiple lesions. LIMA may represent a valid therapy option for patients with extensive hepatic disease within a multimodal treatment approach.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Viszeralchirurgie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Tinguely, Pascale Marie-Pia; Fusaglia, Matteo; Banz Wüthrich, Vanessa; Weber, Stefan and Candinas, Daniel

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0930-2794

Publisher:

Springer

Language:

English

Submitter:

Lars Marius Schwalbe

Date Deposited:

08 Jun 2017 12:45

Last Modified:

08 Feb 2018 14:49

Publisher DOI:

10.1007/s00464-017-5458-4

Related URLs:

PubMed ID:

28342124

Uncontrolled Keywords:

Ablation; Image-guided surgery; Laparoscopy; Liver; Minimal invasive surgery; Surgical navigation

BORIS DOI:

10.7892/boris.98336

URI:

https://boris.unibe.ch/id/eprint/98336

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