Minimally invasive surgery using the open magnetic resonance imaging system combined with video-assisted thoracoscopic surgery for synchronous hepatic and pulmonary metastases from colorectal cancer: report of four cases

Abstract

Simultaneous resection of hepatic and pulmonary metastases (HPM) from colorectal cancer (CRC) has been reported to be effective, but it is also considered invasive. We report the preliminary results of performing minimally invasive surgery using the open magnetic resonance (MR) imaging system to resect synchronous HPM from CRC in four patients. All four patients were referred for thoracoscopy-assisted interventional MR-guided microwave coagulation therapy (T-IVMR-MCT) combined with video-assisted thoracoscopic surgery (VATS). The median diameters of the HPM were 18.2 and 23.2 mm, respectively. The median duration of VATS and T-IVMR-MCT was 82.5 and 139 min, respectively. All patients were discharged without any major postoperative complications. One patient was still free of disease at 24 months and the others died of disease progression 13, 36, and 47 months without evidence of recurrence in the treated area. Thus, simultaneous VATS + T-IVMR-MCT appears to be an effective option as a minimally invasive treatment for synchronous HPM from CRC.

A Study of Complete Video-Assisted Thoracoscopic Surgery Lobectomy in Treatment of Elderly Patients with Non-Small Cell Lung Cancer: Curative Effect and Impact on Clinical Prognosis

“…The difference in the number of excised lymph nodes between two groups was not statistically significant, which verified the feasibility of c-VATS lymph nodes dissection. The difference in blood loss between two groups was not statistically significant, which was inconsistent with some reports [16]. The may be caused by unskilled operation of equipment by surgeons and inadequate preparation to deal with unexpected situations.…”

Magnetic resonance and ultrasound image‐guided navigation system using a needle manipulator

“…This navigation system leveraged the unique scanner configuration, allowing physicians to access the patient in the bore during scanning, and hence enabling interactive planning and targeting using a handheld needle guide . This system was subsequently successfully employed for microwave ablations of liver tumors in more than 300 clinical cases from 2000 to 2016 . We recently developed an MRI‐compatible cooperative needle manipulator to replace the handheld needle guide, providing more interactive and accurate targeting, and successfully clinically tested this system for 23 ablation cases .…”

“…10,11 This system was subsequently successfully employed for microwave ablations of liver tumors in more than 300 clinical cases from 2000 to 2016. [6][7][8][12][13][14] We recently developed an MRI-compatible cooperative needle manipulator 15 to replace the handheld needle guide, providing more interactive and accurate targeting, and successfully clinically tested this system for 23 ablation cases. 16 The study demonstrated that the physical assistance provided by the cooperative needle manipulator improved targeting interactivity under MRI guidance and helped reduce trial-and-error attempts before reaching the target.…”