Robotic navigation-assisted percutaneous liver puncture: a pilot study

Liver cancer is often diagnosed at an advanced stage, rendering many cases unresectable and necessitating minimally invasive treatments such as ablation, for which accurate puncture is essential. Manual techniques are limited by steep learning curves, frequent needle adjustments, and increased radiation exposure. Robotic navigation-assisted puncture (RNAP) offers improved precision, efficiency, and safety, but its efficacy compared to that of manual puncture (MP) remains unclear. This study aimed to assess the safety and efficacy of RNAP in the treatment of liver tumors.

From October 2023 to February 2024, 65 patients with liver tumors underwent percutaneous puncture procedures (ablation, iodine-125 implantation, and biopsy) at department of interventional radiology. They were divided into two groups: the RNAP group (n=29) and the MP group (n=36). Two techniques were compared in terms of technical success (TS), clinical success (CS), puncture scoring (PS), number of computed tomography (CT) scans, total procedure time (TPT), puncture time (PT), irradiation dose (ID), and puncture-related complications.

There were significant differences between patients in the RNAP group and those in the MP group in terms of PS (3.02±0.68 vs. 2.24±0.73; P=0.01), PT (8.86±1.91 vs. 13.44±3.66 min; P=0.01), number of CT scans (7.03±2.30 vs. 11.58±4.25; P=0.01), and ID (160.76±40.60 vs. 230.06±86.46 mGy·cm; P=0.01); meanwhile, TS (100% vs. 100%; P>0.99), CS (91.50% vs. 91.40%; P=0.81), TPT (33.22±7.80 vs. 32.13±5.50 min; P=0.52), and complications (10.30% vs. 5.56%; P=0.47) showed no differences.

RNAP is a useful tool for performing puncture procedures on liver tumors, which can decrease PT, CT scan times, and ID.