Abstract No. 33 Safety and Accuracy of Robotic-Assisted Microwave Ablation: First American Experience

To evaluate the safety and accuracy of robotic-assisted microwave ablation using the Epione (Quantum Surgical) robotic system. This is a single-center retrospective experience with microwave ablation of the liver using the Epione robotic system for planning, and guidance for antenna placement. Between May and July of 2023, 21 patients had 30 lesions treated with microwave ablation under general anesthesia using CT-guidance and robotic assistance for planning and placement of the microwave antenna. Twenty-nine of the 30 lesions were treated with single microwave antennas. One lesion was treated with simultaneous microwave ablation following the placement of 2 antennas. Safety was assessed with immediate post ablation contrast-enhanced CT and review of follow-up imaging. Accuracy of the robotic placement was calculated by comparing the planned trajectory with the actual location of the antenna tip with an assessment of any deviation from the planned trajectory. All antenna placements were performed with a single push from skin to target. There were no complications related to antenna placement with robotic guidance in the immediate contrast-enhanced CT scans or follow up imaging. All patients had successful microwave ablations. Twenty-seven of 34 trajectories (80%) were accurate after the first insertion with 13 of the 34 (38.23%) trajectories requiring no adjustments. Fourteen of the 34 (41.17%) trajectories required minor depth adjustments. Six of the 34 (17.6%) trajectories were judged to be clinically accurate after minor lateral adjustments. One of the 34 (2.9%) required 3 robotic insertion attempts to be clinically accurate. The Epione robotic-guided antenna insertions had a 97% first-pass accuracy with minimal or no adjustments to reach the target, enabling successful ablations. This retrospective study confirms the safety of robotic-guided planning and placement of microwave antennas with a high level of accuracy. Additional prospective trials will further define other value propositions such as savings in time and radiation exposure to both the patient and the operator.