Novel robotic navigation system for CT-guided lung ablation: First efficacy and safety evaluation.

Abstract

e20070 Background: Microwave ablation is a widely used technique for treating solid tumors. MWA focuses energy to minimize damage to surrounding tissues, requiring precise energy distribution and puncture planning. Physicians traditionally rely on experience for puncture planning and execution. However, manual puncture struggles with accuracy due to factors like respiratory movements and patient position changes, often necessitating multiple adjustments and sometimes resulting in procedure failure due to complications. Robotic navigation systems can plan and execute punctures with high precision, minimizing damage to normal tissues. Yet, there is currently no strong evidence supporting the feasibility and safety of robotic navigation systems in CT-guided percutaneous MWA of pulmonary nodules. Methods: This research examined the application of the TH-S1 robotic device (China) for percutaneous puncture needle microwave pulmonary nodule ablation. The primary evaluation metrics encompassed the feasibility of achieving thermal ablation post robot-guided needle insertion, the frequency of needle repositioning maneuvers (the count of additional robot-assisted needle placements required when the initial positioning was not adequate for ablation), and the safety of the procedure (incidence of complications) related to needle insertion. Post-intervention patients were followed up for 3-6 months to assess localized control. Results: A total of 71 patients were included with a total of 74 lesions with a mean lesion diameter of 9.63 ± 5.02 mm. By using robot-assisted thermal ablation, all operations were successfully completed without failures in 74 lesions in 71 patients. The mean number of needle adjustments required per treated tumor was 1.03 (standard deviation 1.11), with 41.89% of the lung nodules requiring no adjustment. Fourteen patients developed a small pneumothorax, of which twelve were observed and required no special treatment and two required tube drainage. At 3 months, all treated pulmonary nodules disappeared in CT imaging. Conclusions: The feasibility, accuracy and safety of TH-S1 robotic-guided percutaneous puncture insertion for thermal ablation of pulmonary nodules were validated. Analysis of treatment characteristics in TH-S1 robotic-guided percutaneous puncture insertion for thermal ablation of pulmonary nodules. Characteristics Values Ablation needle specification Danhui16G 11 (14.86%) Nanjing Fuzhong 16G 8 (10.81%) Nanjing Fuzhong 17G 55 (74.32%) Puncture time (min) 19.85 ± 13.78 Treatment time (min) 4.27 ± 2.18 Total treatment time (min) 24.12 ± 15.13 Target deviation Without deviation 35 (47.30%) Foot side 22 (29.73%) Head side 17 (22.97%) Target deviation distance (mm) 4.54 ± 3.19 Number of needle adjustments 0 31 (41.89%) 1 20 (27.03%) 2 16 (21.62%) 3 4 (5.41%) 4 3 (4.05%) Mean 1.03 ± 1.11 Complication N (%) Without complication 57 (80.28%) Pneumothorax 14 (19.72%)