Sastry Amit V, Swet Jacob H, Murphy Keith J, Baker Erin H, Vrochides Dionisios, Martinie John B, McKillop Iain H, Iannitti David A
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.
HPB (Oxford). 2017 Dec;19(12):1066-1073. doi: 10.1016/j.hpb.2017.08.001. Epub 2017 Sep 13.
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.
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.
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.
Emprint™ SX significantly improved accuracy and speed of antenna-placement independent of experience, and was particularly beneficial for novice users.
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。
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。
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。
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。