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Design and development of adapters for electromagnetic trackers to perform navigated laparoscopic radiofrequency ablation

机译:电磁跟踪仪适配器的设计和开发,以进行导航式腹腔镜射频消融

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Background Laparoscopic radiofrequency ablation (RFA) is an accepted approach to treat unresectable liver tumours distinguishing itself from other techniques by combining minimal invasiveness and the advantages of a surgical approach. The major task of laparoscopic RFA is the accurate needle placement to achieve complete tumour ablation. The use of an ultrasound-based, laparoscopic online-navigation system could increase the safety and accuracy of punctures. To connect such a system with the laparoscopic ultrasound (LUS) transducer or the RFA needle especially designed adapters are needed. In this article we present our first experiences and prototypes for different sterilizable adapters for an electromagnetic navigation system for laparoscopic RFA. Methods All adapters were constructed with the help of a standard 3D CAD software. The adapters were built from medical stainless steel alloys and polyetherketone (PEEK). Prototypes were built in aluminium and polyoxymethilen (POM). We have designed and developed several adapters for the connection of electromagnetical tracking systems with different RFA needles and a laparoscopic ultrasound transducers. Results Based on earlier experiences of the initial version of the adapter, sterilisable adapters have been developed using biocompatible materials only. After short introduction, the adapters could be mounted to the laparoscopic ultrasound probe and the RFA needle under sterile conditions without any difficulties. Laboratory tests showed no disturbance of laparoscopic navigation system by the adapters. Anatomic landmarks in the liver could be safely reached. The adapters showed good feasibility, ergonomics, sterilizability and stability. Conclusion The development of usable adapters is the prerequisite for accurate tracking of a RFA needle for laparoscopic navigation purposes as well as 3D navigated ultrasound data acquisition. We designed, tested and used different adapters for the use of a laparoscopic navigation system for the improvement of laparoscopic RFA.
机译:背景技术腹腔镜射频消融(RFA)是一种治疗不可切除的肝肿瘤的公认方法,该方法通过将微创和手术方法的优势相结合,将自身与其他技术区分开来。腹腔镜RFA的主要任务是准确地放置针头以实现完全的肿瘤消融。基于超声波的腹腔镜在线导航系统的使用可以提高穿刺的安全性和准确性。要将此类系统与腹腔镜超声(LUS)换能器或RFA针连接,需要专门设计的适配器。在本文中,我们介绍了用于腹腔镜RFA电磁导航系统的各种可消毒适配器的最初经验和原型。方法所有适配器均借助标准3D CAD软件构建。适配器由医用不锈钢合金和聚醚酮(PEEK)制成。原型建立在铝和聚氧甲烯(POM)中。我们设计和开发了几种适配器,用于将电磁跟踪系统与不同的RFA针头和腹腔镜超声换能器连接。结果基于适配器初始版本的早期经验,仅使用生物相容性材料开发了可消毒适配器。简短介绍后,可以在无菌条件下毫无问题地将适配器安装到腹腔镜超声探头和RFA针上。实验室测试表明,适配器不会干扰腹腔镜导航系统。可以安全地到达肝脏的解剖标志。适配器显示出良好的可行性,人体工程学,可消毒性和稳定性。结论开发适用的适配器是精确跟踪RFA针以进行腹腔镜导航以及3D导航超声数据采集的先决条件。我们设计,测试并使用了不同的适配器,以使用腹腔镜导航系统来改善腹腔镜RFA。

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