Laparoscopic microwave ablation of human liver tumours using a novel three-dimensional magnetic guidance system

Abstract Background Accurate antenna placement is essential for effective microwave ablation (MWA) of lesions. Laparoscopic targeting is made particularly challenging in liver tumours by the needle's trajectory as it passes through the abdominal wall into the liver. Previous optical three-dimen...

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Veröffentlicht in:HPB (Oxford, England) England), 2015-01, Vol.17 (1), p.87-93
Hauptverfasser: Sindram, David, Simo, Kerri A, Swan, Ryan Z, Razzaque, Sharif, Niemeyer, David J, Seshadri, Ramanathan M, Hanna, Erin, McKillop, Iain H, Iannitti, David A, Martinie, John B
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container_issue 1
container_start_page 87
container_title HPB (Oxford, England)
container_volume 17
creator Sindram, David
Simo, Kerri A
Swan, Ryan Z
Razzaque, Sharif
Niemeyer, David J
Seshadri, Ramanathan M
Hanna, Erin
McKillop, Iain H
Iannitti, David A
Martinie, John B
description Abstract Background Accurate antenna placement is essential for effective microwave ablation (MWA) of lesions. Laparoscopic targeting is made particularly challenging in liver tumours by the needle's trajectory as it passes through the abdominal wall into the liver. Previous optical three-dimensional guidance systems employing infrared technology have been limited by interference with the line of sight during procedures. Objective The aim of this study was to evaluate a newly developed magnetic guidance system for laparoscopic MWA of liver tumours in a pilot study. Methods Thirteen patients undergoing laparoscopic MWA of liver tumours gave consent to their participation in the study and were enrolled. Lesion targeting was performed using the InnerOptic AIM™ 3-D guidance system to track the real-time position and orientation of the antenna and ultrasound probe. Results A total of 45 ablations were performed on 34 lesions. The median number of lesions per patient was two. The mean ± standard deviation lesion diameter was 18.0 ± 9.2 mm and the mean time to target acquisition was 3.5 min. The first-attempt success rate was 93%. There were no intraoperative or immediate postoperative complications. Over an average follow-up of 7.8 months, one patient was noted to have had an incomplete ablation, seven suffered regional recurrences, and five patients remained disease-free. Conclusions The AIM™ guidance system is an effective adjunct for laparoscopic ablation. It facilitates a high degree of accuracy and a good first-attempt success rate, and avoids the line of site interference associated with infrared systems.
doi_str_mv 10.1111/hpb.12315
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Laparoscopic targeting is made particularly challenging in liver tumours by the needle's trajectory as it passes through the abdominal wall into the liver. Previous optical three-dimensional guidance systems employing infrared technology have been limited by interference with the line of sight during procedures. Objective The aim of this study was to evaluate a newly developed magnetic guidance system for laparoscopic MWA of liver tumours in a pilot study. Methods Thirteen patients undergoing laparoscopic MWA of liver tumours gave consent to their participation in the study and were enrolled. Lesion targeting was performed using the InnerOptic AIM™ 3-D guidance system to track the real-time position and orientation of the antenna and ultrasound probe. Results A total of 45 ablations were performed on 34 lesions. The median number of lesions per patient was two. The mean ± standard deviation lesion diameter was 18.0 ± 9.2 mm and the mean time to target acquisition was 3.5 min. The first-attempt success rate was 93%. There were no intraoperative or immediate postoperative complications. Over an average follow-up of 7.8 months, one patient was noted to have had an incomplete ablation, seven suffered regional recurrences, and five patients remained disease-free. Conclusions The AIM™ guidance system is an effective adjunct for laparoscopic ablation. It facilitates a high degree of accuracy and a good first-attempt success rate, and avoids the line of site interference associated with infrared systems.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1111/hpb.12315</identifier><identifier>PMID: 25231167</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Ablation Techniques - instrumentation ; Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Equipment Design ; Female ; Gastroenterology and Hepatology ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional - instrumentation ; Laparoscopy - instrumentation ; Laparoscopy - methods ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Magnetics - instrumentation ; Magnetics - methods ; Male ; Materials Testing ; Microwaves - therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local ; Original ; Pilot Projects ; Predictive Value of Tests ; Prospective Studies ; Surgery, Computer-Assisted - instrumentation ; Surgery, Computer-Assisted - methods ; Time Factors ; Transducers ; Treatment Outcome ; Ultrasonography, Interventional - instrumentation ; Ultrasonography, Interventional - methods</subject><ispartof>HPB (Oxford, England), 2015-01, Vol.17 (1), p.87-93</ispartof><rights>International Hepato-Pancreato-Biliary Association</rights><rights>2014 International Hepato-Pancreato-Biliary Association</rights><rights>2014 International Hepato‐Pancreato‐Biliary Association</rights><rights>2014 International Hepato-Pancreato-Biliary Association.</rights><rights>Copyright © 2015 International Hepato-Pancreato-Biliary Association</rights><rights>2014 International Hepato-Pancreato-Biliary Association 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5425-35de7cb0a5dbcf9331f00dd2b3fe5b266b6a9541e8baf1456deab798334bcb3a3</citedby><cites>FETCH-LOGICAL-c5425-35de7cb0a5dbcf9331f00dd2b3fe5b266b6a9541e8baf1456deab798334bcb3a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266445/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266445/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25231167$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sindram, David</creatorcontrib><creatorcontrib>Simo, Kerri A</creatorcontrib><creatorcontrib>Swan, Ryan Z</creatorcontrib><creatorcontrib>Razzaque, Sharif</creatorcontrib><creatorcontrib>Niemeyer, David J</creatorcontrib><creatorcontrib>Seshadri, Ramanathan M</creatorcontrib><creatorcontrib>Hanna, Erin</creatorcontrib><creatorcontrib>McKillop, Iain H</creatorcontrib><creatorcontrib>Iannitti, David A</creatorcontrib><creatorcontrib>Martinie, John B</creatorcontrib><title>Laparoscopic microwave ablation of human liver tumours using a novel three-dimensional magnetic guidance system</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>Abstract Background Accurate antenna placement is essential for effective microwave ablation (MWA) of lesions. Laparoscopic targeting is made particularly challenging in liver tumours by the needle's trajectory as it passes through the abdominal wall into the liver. Previous optical three-dimensional guidance systems employing infrared technology have been limited by interference with the line of sight during procedures. Objective The aim of this study was to evaluate a newly developed magnetic guidance system for laparoscopic MWA of liver tumours in a pilot study. Methods Thirteen patients undergoing laparoscopic MWA of liver tumours gave consent to their participation in the study and were enrolled. Lesion targeting was performed using the InnerOptic AIM™ 3-D guidance system to track the real-time position and orientation of the antenna and ultrasound probe. Results A total of 45 ablations were performed on 34 lesions. The median number of lesions per patient was two. The mean ± standard deviation lesion diameter was 18.0 ± 9.2 mm and the mean time to target acquisition was 3.5 min. The first-attempt success rate was 93%. There were no intraoperative or immediate postoperative complications. Over an average follow-up of 7.8 months, one patient was noted to have had an incomplete ablation, seven suffered regional recurrences, and five patients remained disease-free. Conclusions The AIM™ guidance system is an effective adjunct for laparoscopic ablation. 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Simo, Kerri A ; Swan, Ryan Z ; Razzaque, Sharif ; Niemeyer, David J ; Seshadri, Ramanathan M ; Hanna, Erin ; McKillop, Iain H ; Iannitti, David A ; Martinie, John B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5425-35de7cb0a5dbcf9331f00dd2b3fe5b266b6a9541e8baf1456deab798334bcb3a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Ablation Techniques - instrumentation</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Disease-Free Survival</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Imaging, Three-Dimensional - instrumentation</topic><topic>Laparoscopy - instrumentation</topic><topic>Laparoscopy - methods</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Magnetics - instrumentation</topic><topic>Magnetics - methods</topic><topic>Male</topic><topic>Materials Testing</topic><topic>Microwaves - therapeutic use</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Original</topic><topic>Pilot Projects</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Surgery, Computer-Assisted - instrumentation</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Time Factors</topic><topic>Transducers</topic><topic>Treatment Outcome</topic><topic>Ultrasonography, Interventional - instrumentation</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sindram, David</creatorcontrib><creatorcontrib>Simo, Kerri A</creatorcontrib><creatorcontrib>Swan, Ryan Z</creatorcontrib><creatorcontrib>Razzaque, Sharif</creatorcontrib><creatorcontrib>Niemeyer, David J</creatorcontrib><creatorcontrib>Seshadri, Ramanathan M</creatorcontrib><creatorcontrib>Hanna, Erin</creatorcontrib><creatorcontrib>McKillop, Iain H</creatorcontrib><creatorcontrib>Iannitti, David A</creatorcontrib><creatorcontrib>Martinie, John B</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sindram, David</au><au>Simo, Kerri A</au><au>Swan, Ryan Z</au><au>Razzaque, Sharif</au><au>Niemeyer, David J</au><au>Seshadri, Ramanathan M</au><au>Hanna, Erin</au><au>McKillop, Iain H</au><au>Iannitti, David A</au><au>Martinie, John B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic microwave ablation of human liver tumours using a novel three-dimensional magnetic guidance system</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2015-01</date><risdate>2015</risdate><volume>17</volume><issue>1</issue><spage>87</spage><epage>93</epage><pages>87-93</pages><issn>1365-182X</issn><eissn>1477-2574</eissn><abstract>Abstract Background Accurate antenna placement is essential for effective microwave ablation (MWA) of lesions. Laparoscopic targeting is made particularly challenging in liver tumours by the needle's trajectory as it passes through the abdominal wall into the liver. Previous optical three-dimensional guidance systems employing infrared technology have been limited by interference with the line of sight during procedures. Objective The aim of this study was to evaluate a newly developed magnetic guidance system for laparoscopic MWA of liver tumours in a pilot study. Methods Thirteen patients undergoing laparoscopic MWA of liver tumours gave consent to their participation in the study and were enrolled. Lesion targeting was performed using the InnerOptic AIM™ 3-D guidance system to track the real-time position and orientation of the antenna and ultrasound probe. Results A total of 45 ablations were performed on 34 lesions. The median number of lesions per patient was two. The mean ± standard deviation lesion diameter was 18.0 ± 9.2 mm and the mean time to target acquisition was 3.5 min. The first-attempt success rate was 93%. There were no intraoperative or immediate postoperative complications. Over an average follow-up of 7.8 months, one patient was noted to have had an incomplete ablation, seven suffered regional recurrences, and five patients remained disease-free. Conclusions The AIM™ guidance system is an effective adjunct for laparoscopic ablation. It facilitates a high degree of accuracy and a good first-attempt success rate, and avoids the line of site interference associated with infrared systems.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>25231167</pmid><doi>10.1111/hpb.12315</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Ablation Techniques - instrumentation
Adult
Aged
Aged, 80 and over
Disease-Free Survival
Equipment Design
Female
Gastroenterology and Hepatology
Humans
Image Interpretation, Computer-Assisted
Imaging, Three-Dimensional - instrumentation
Laparoscopy - instrumentation
Laparoscopy - methods
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Magnetics - instrumentation
Magnetics - methods
Male
Materials Testing
Microwaves - therapeutic use
Middle Aged
Neoplasm Recurrence, Local
Original
Pilot Projects
Predictive Value of Tests
Prospective Studies
Surgery, Computer-Assisted - instrumentation
Surgery, Computer-Assisted - methods
Time Factors
Transducers
Treatment Outcome
Ultrasonography, Interventional - instrumentation
Ultrasonography, Interventional - methods
title Laparoscopic microwave ablation of human liver tumours using a novel three-dimensional magnetic guidance system
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