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一种新型三维电磁引导系统提高了术中微波天线放置的准确性。

A novel 3-dimensional electromagnetic guidance system increases intraoperative microwave antenna placement accuracy.

作者信息

Sastry Amit V, Swet Jacob H, Murphy Keith J, Baker Erin H, Vrochides Dionisios, Martinie John B, McKillop Iain H, Iannitti David A

机构信息

Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.

Division of Hepato-Pancreato-Biliary Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.

出版信息

HPB (Oxford). 2017 Dec;19(12):1066-1073. doi: 10.1016/j.hpb.2017.08.001. Epub 2017 Sep 13.

Abstract

BACKGROUND

Failure to locate lesions and accurately place microwave antennas can lead to incomplete tumor ablation. The Emprint™ SX Ablation Platform employs real-time 3D-electromagnetic spatial antenna tracking to generate intraoperative laparoscopic antenna guidance. We sought to determine whether Emprint™ SX affected time/accuracy of antenna-placement in a laparoscopic training model.

METHODS

Targets (7-10 mm) were set in agar within a laparoscopic training device. Novices (no surgical experience), intermediates (surgical residents), and experts (HPB-surgeons) were asked to locate and hit targets using a MWA antenna (10-ultrasound only, 10-Emprint™ SX). Time to locate target, number of attempts to hit the target, first-time hit rate, and time from initiating antenna advance to hitting the target were measured.

RESULTS

Participants located 100% of targets using ultrasound, with experts taking significantly less time than novices and intermediates. Using ultrasound only, successful hit-rates were 70% for novices and 90% for intermediates and experts. Using Emprint™ SX, successful hit rates for all 3-groups were 100%, with significantly increased first-time hit-rates and reduced time required to hit targets compared to ultrasound only.

DISCUSSION

Emprint™ SX significantly improved accuracy and speed of antenna-placement independent of experience, and was particularly beneficial for novice users.

摘要

背景

未能定位病变并准确放置微波天线可能导致肿瘤消融不完全。Emprint™ SX消融平台采用实时三维电磁空间天线跟踪技术,以生成术中腹腔镜天线引导。我们试图确定Emprint™ SX在腹腔镜训练模型中是否会影响天线放置的时间/准确性。

方法

在腹腔镜训练装置内的琼脂中设置目标(7 - 10毫米)。要求新手(无手术经验)、中级人员(外科住院医师)和专家(肝脏胰腺胆管外科医生)使用微波消融天线(10个仅使用超声,10个使用Emprint™ SX)定位并击中目标。测量定位目标的时间、击中目标的尝试次数、首次命中率以及从开始推进天线到击中目标的时间。

结果

参与者使用超声能100%定位目标,专家所用时间明显少于新手和中级人员。仅使用超声时,新手的成功率为70%,中级人员和专家为90%。使用Emprint™ SX时,所有三组的成功率均为100%,与仅使用超声相比,首次命中率显著提高,击中目标所需时间减少。

讨论

Emprint™ SX显著提高了天线放置的准确性和速度,与经验无关,对新手用户尤其有益。

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