Novel Non-Trocar Technique for Laparoscopic Radiofrequency Ablation

Abstract

We have developed a novel insertion method, a non-trocar technique (NTT), for laparoscopic radiofrequency ablation, whereby an ablation needle, guided by a 14.8-mm echo probe (PVM-787LA; Toshiba, Tokyo, Japan), accurately and easily punctures the target tumor in the liver. By existing methods, an ablation needle is inserted into the abdominal cavity through a puncture hole away from the echo probe because of the presence of a 15-mm trocar. Under such circumstances, fitting and sliding an ablation needle along the groove of the probe into the abdominal cavity is difficult because of the longitudinal dissociation between the needle and the probe. To avoid this dissociation, an echo probe is inserted directly through the small incision from which the 12-mm trocar is withdrawn and an ablation needle is introduced directly into the abdominal cavity through a puncture hole adjacent to and slid along the groove of the probe.

Needle Insertion in Laparoscopic Thermoablation of the Liver

“…The MCT needle has been introduced besides the ultrasound probe and parallely inserted. Tsuchida et al [3] describe this technique in detail. The limitations are however obvious: Due to the fixed geometry of the forward-looking probe and the axial access to the target area, the technique is best applied to the ventral and caudal parts of the liver.…”

Viral Hepatitis and Hepatocellular Carcinoma: Update in 2012

“…Makino et al [7] reported that the multimodality fusion imaging system has become quite an important tool for locoregional treatment of HCC because of its usefulness for both the guidance during the radiofrequency ablation procedure and the evaluation of its treatment effects. Tsuchida et al [8] reported on a novel insertion method, a non-trocar technique, for laparoscopic radiofrequency ablation with the use of a convex scanning probe, whereby an ablation needle accurately and easily punctures the target tumor in the liver.…”