RESUMEN
BACKGROUND: Intraoperative blood loss during liver resection may be minimized by ablating the liver parenchyma using radiofrequency (RF) energy. However, it is difficult to estimate the depth of the avascular plane and more RF energy than necessary may be inadvertently used as a result of lack of feedback. METHODS: Laparoscopic liver resection was performed on a live porcine model to determine the feasibility and applicability of a model which integrates ablation and division in a single device. RESULTS: Liver resection was uncomplicated with minimal bleeding. The integration of the ablation and division mechanism resolved the difficulty of estimating the depth of the avascular plane after coagulation. The real-time feedback mechanism minimized liver damage by eliminating the application of unnecessary RF. CONCLUSIONS: The proposed model is functionally acceptable and represents a possible method of determining the depth of the avascular plane and the amount of RF energy required during liver resection.
Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control , Ablación por Catéter/instrumentación , Ablación por Catéter/métodos , Hígado/cirugía , Animales , Estudios de Factibilidad , Laparoscopía/instrumentación , Laparoscopía/métodos , Hígado/irrigación sanguínea , Modelos Animales , PorcinosRESUMEN
Radiofrequecy ablation is the most widely used local ablative therapy for both primary and metastatic liver tumours. However, it has limited application in the treatment of large tumours (tumours >3cm) and multicentric tumours. In recent years, many strategies have been developed to extend the application of radiofrequency ablation to large tumours. A promising approach is to take advantage of the rapid advancement in imaging and robotic technologies to construct an integrated surgical navigation and medical robotic system. This paper presents a review of existing surgical navigation methods and medical robots. We also introduce our current developed model - Transcutaneous Robot-assisted Ablation-device Insertion Navigation System (TRAINS). The clinical viability of this prototyped integrated navigation and robotic system for large and multicentric tumors is demonstrated using animal experiments.