ire of hcc with robotic assistance lukas p. beyer, benedikt pregler, christoph nießen, philipp...

7
IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Upload: joy-murphy

Post on 18-Jan-2018

219 views

Category:

Documents


0 download

DESCRIPTION

Preinterventional CT V. umbilicalis HCC arterial phase

TRANSCRIPT

Page 1: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

IRE of HCC with robotic assistance

Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp

Wiggermann

Page 2: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Patient history

• 62 years old, male• Liver cirrhosis Child B• Successfull microwave ablation of HCC in

segment VII (03/2014)• HCC in segment IVa– 3,4 x 3,0 cm– next to portal vein and recanalised V. umbilicalis

Page 3: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Preinterventional CT

V. umbilicalis

HCC

arterial phase

Page 4: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Procedure

• IRE– Simultaneous placement of 5 needles– No heat sink effect

• Robotic guidance (Perfint MAXIO)– Avoids use of CT fluoroscopy– Simultaneous placement of up to 6 probes– Exact positioning (+- 1mm)– Faster interventions

Page 5: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Assisted needle placement

Semi-automatic needle placement with Perfint MAXIO

Page 6: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

native control scan

Periinterventional CT

IRE needle

V. umbilicalis

ablation area

Page 7: IRE of HCC with robotic assistance Lukas P. Beyer, Benedikt Pregler, Christoph Nießen, Philipp Wiggermann

Follow-up (12 weeks)complete ablation

• no peri- or postinterventional complications• complete ablation in CEUS, MRI and CT