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Robotic-assisted CT-guided percutaneous thermal ablation of abdominal tumors: An analysis of 41 patients - 02/06/24

Doi : 10.1016/j.diii.2024.01.005 
Baptiste Bonnet a, Thierry de Baère a, b, c, , Paul Beunon a, Adlane Feddal a, Lambros Tselikas a, b, c, Frédéric Deschamps a, b
a Centre d'Investigation Clinique BIOTHERIS, INSERM CIC1428, Radiologie Interventionnelle; Laboratoire de Recherche Translationnelle en Immunothérapie (LRTI), INSERM U1015, 94805 Villejuif, France 
b Gustave Roussy, Service d'Imagerie Thérapeutique, Département d'Anesthésie, Chirurgie et Interventionnel (DACI), 94805 Villejuif, France 
c Faculté de Médecine, Paris-Saclay Université, 94270 Le Kremlin Bicêtre, France 

Corresponding author.

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Highlights

Computed tomography-guided percutaneous thermal ablation of abdominal tumors using robotic guidance is highly feasible.
Robotic assistance is safe and effective for computed-tomography guided percutaneous thermal ablation of abdominal tumors.
Robotic assistance is an asset for challenging trajectories and interventions requiring multiple needle placements.

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Abstract

Purpose

Robotic assistance is rapidly evolving and may help physicians optimize needle guidance during percutaneous interventions. The purpose of the study was to report feasibility, safety, accuracy, immediate clinical success and short-term local tumor control after robotic-assisted computed tomography (CT)-guided thermal ablation of abdominal tumors.

Materials and methods

Forty-one patients who underwent percutaneous thermal ablation of abdominal tumors using robotic-assisted CT-guided were included. All ablations were performed with robotic assistance, using an optically-monitored robotic system with a needle guide sent to preplanned trajectories defined on three-dimensional-volumetric CT acquisitions with respiration monitoring. Endpoints were technical success, safety, distance from needle tip to planned trajectory and number of needle adjustments, and complete ablation rate.

Results

Forty-one patients (31 men; mean age, 66.7 ± 9.9 [standard deviation (SD)] years [age range: 41–84 years]) were treated for 48 abdominal tumors, with 79 planned needles. Lesions treated were located in the liver (23/41; 56%), kidney (14/41;34%), adrenal gland (3/41; 7%) or retroperitoneum (1/41; 2%). Technical success was achieved in 39/41 (95%) patients, and 76/79 (96%) needle insertions. The mean lateral distance between the needle tip and planned trajectory was 3.2 ± 4.5 (SD) mm (range: 0–20 mm) before adjustments, and the mean three-dimensional distance was 1.6 ± 2.6 (SD) mm (range: 0–13 mm) after 29 manual depth adjustments (29/78; 37%) and 33 lateral adjustments (33/78; 42%). Two (2/79; 3%) needles required complete manual reinsertion. One grade 3 complication was reported in one patient (1/41; 2%). The overall clinical success rate was 100%. The 3-month local tumor control rate (progression free survival) was 95% (38/41).

Conclusion

These results provide further evidence on the use of robotic-assisted needle insertion regarding feasibility, safety, and accuracy, resulting in effective percutaneous thermal ablation of abdominal tumors.

El texto completo de este artículo está disponible en PDF.

Keywords : Abdominal neoplasms, CT-guided procedures, Feasibility studies, Percutaneous thermal ablation, Robotic procedures

Abbreviations : 3D, CT, SD


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© 2024  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 105 - N° 6

P. 227-232 - juin 2024 Regresar al número
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