Tumor Ablation Treatment Planning Coupled to Robotic Implementation: A Feasibility Study

Abstract

The technical development described herein was undertaken to create a tumor ablation treatment system that consists of a software component and a robotic hardware component. First, the software treatment planning system enables applicator placement planning before tumor ablation. For example, it allows creation of overlapping ablations with the goal of treating larger tumors. Second, the robotic hardware system allows accurate applicator placement. The combined treatment system integrates treatment planning with treatment execution by taking the coordinates dictated by the planning system and feeding them to the robotic system for implementation. The feasibility of this system was tested in two patients with large hepatic metastases that required overlapping ablations. J Vasc Interv Radiol 2006; 17:903-907Abbreviation: RF ϭ radiofrequency

The first clinical application of planning software for laparoscopic microwave thermosphere ablation of malignant liver tumours

“…As shown in other abdominal surgical procedures, robotic assistance can improve the precision of antenna placement. There is ongoing work in automation of this process for percutaneous ablation with robots used in CT scanner units; however, developing an automated laparoscopic needle/antenna placement system for liver tumour ablation involves more complex tasks, such as being able to provide augmented reality and adjusting to different needle angles in a given patient, based on the relationship between the costal margin, liver and visceral organs. Nevertheless, with the developments in robotic surgical systems, future advances are possible in this field.…”

“…Solomon et al . have reported on a percutaneous tumour ablation planning coupled to robotic needle placement.…”

“…Microwave thermosphere ablation is a newer technology, which offers significant advantages when compared with RFA, in terms of more efficient tissue heating, with potentially shorter ablation times and fewer treatment failures owing to a less prominent ‘heat sink effect’ . Although there are reports on pre‐planning for percutaneous RFA under computer tomography (CT) guidance in the radiology literature, pre‐planning for a surgical liver tumour ablation is a new concept, with no reports on MWA. The aim of this study was to describe the initial clinical use of a new, planning software for microwave thermosphere ablation of malignant liver tumours.…”

Robotic Systems: Past, Present, and Future

“…At the Johns Hopkins University our team has developed several needle driving systems under various X-Ray-based guidance modalities and performed numerous clinical tests for urology applications. [15][16][17][18][19][20] Simultaneously, other research teams worked on the concept of remote manipulation mostly for augmenting the performance of minimally invasive surgery. 21 The first system was named Artemis (Advanced Robotic Telemanipulator for Minimally Invasive Surgery).…”

Robotically assisted needle driver: evaluation of safety release, force profiles, and needle spin in a swine abdominal model

“…Computers and robots have been used in combination with these procedures and have demonstrated enhanced performance under direct physician guidance simultaneous with human input as compared to the more conventional method of the physician alone, without robotic assistance [3]. Feasibility studies have been presented by Solomon et al [4] to develop a tumor ablation treatment system that utilizes the Acubot robot system for accurate applicator placement tested in patients. A robotically assisted needle insertion system for prostate brachytherapy has also been tested in phantoms by Fichtinger et al [5].…”