Laparoscopic Microwave Ablation: Which Technologies Improve the Results

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Oncology
• Medical Imaging Technologies

Background:

• Hepatocellular carcinoma (HCC) often precludes liver resection, necessitating alternative treatments.
• Percutaneous thermoablation is an option for inoperable HCC, but not always feasible due to lesion visibility or location.
• Laparoscopic thermoablation is indicated when percutaneous approaches fail, yet intraoperative 3D navigation remains challenging.

Purpose of the Study:

• To explore advanced technologies for improving laparoscopic thermoablation precision in HCC treatment.
• To detail the integration of 3D hepatic modeling, ICG fluorescence, and laparoscopic ultrasound for enhanced surgical planning.
• To demonstrate how these tools facilitate a personalized laparoscopic approach for HCC patients.

Main Methods:

• Utilizing 3D reconstruction of CT/MRI scans for virtual and augmented reality surgical guidance.
• Employing indocyanine green (ICG) fluorescence imaging to delineate tumor margins during laparoscopy.
• Integrating laparoscopic ultrasound with contrast media for improved lesion localization and characterization.

Main Results:

• 3D hepatic modeling aids in precise preoperative surgical planning and intraoperative visualization.
• ICG fluorescence imaging enhances the accuracy of laparoscopic thermoablation.
• Laparoscopic ultrasound with contrast improves the identification and assessment of HCC lesions.

Conclusions:

• Hepatic 3D modeling, ICG fluorescence, and laparoscopic ultrasound are valuable tools for HCC treatment.
• These technologies significantly improve preoperative surgical preparation and enable personalized laparoscopic approaches.
• The combined use of these modalities enhances precision and potentially improves outcomes for laparoscopic thermoablation in HCC.