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. 2022 Jul 22:10:59-68.
doi: 10.1016/j.sopen.2022.07.006. eCollection 2022 Oct.

Ablation technologies

Onuralp Ergun  1 , Mohammed Elshamy  2 , Eren Berber  2
Affiliations

Ablation technologies

Onuralp Ergun et al. Surg Open Sci. .

Abstract

Ablative therapies have recently emerged as an alternate to the gold-standard liver resection in treatment of malignant liver tumors. These modalities include radiofrequency ablation and microwave ablation which utilize thermocoagulative energy and microwave energy, respectively, to create a complete necrosis zone encircling the lesion. In this review, we aimed to show different perspectives of these treatment methods including indications, outcomes, surgical techniques, and perioperative management.

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Figures

Fig 1
Fig 1
Representative RFA catheters of different sizes and configuration.
Fig 2
Fig 2
A representative microwave ablation catheter. Note the antenna design that uses a straight needle, in contrast to the design of RFA catheters.
Fig 3
Fig 3
Illustration showing the use of laparoscopic ultrasound to identify liver tumors.
Fig 4
Fig 4
Use of stand-off technique to visualize tumors located at the periphery of the liver.
Fig 5
Fig 5
Illustration showing the performance of laparoscopic ultrasound-guided biopsy procedure.
Fig 6
Fig 6
Intraoperative photo showing the placement of RFA catheter into the tumors under laparoscopic ultrasound guidance.
Fig 7
Fig 7
Intraoperative photo showing performance of RFA procedure under laparoscopic ultrasound guidance.
Fig 8
Fig 8
Intraoperative photo showing the insertion of a microwave needle into a colorectal liver metastasis under laparoscopic ultrasound guidance.
Fig 9
Fig 9
Intraoperative photo showing performance of microwave ablation procedure under laparoscopic ultrasound guidance.
Fig 10
Fig 10
Intraoperative photo demonstrating operative setup for a laparoscopic RFA procedure.
Fig 11
Fig 11
Intraoperative photo demonstrating operative setup for a laparoscopic microwave ablation procedure.
Fig 12
Fig 12
CT scans of a patient with neuroendocrine live metastases who underwent microwave ablation of multiple bilobar lesions. Follow-up imaging did not demonstrate any local recurrence.
Fig 13
Fig 13
CT images of an elderly patient with a solitary tumor in liver segment 7. After discussing treatment options including liver resection, patient opted for a laparoscopic microwave ablation. Follow-up imaging demonstrated a successful outcome with no evidence of local recurrence.
See this image and copyright information in PMC

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