To prospectively collect and evaluate pre-operative, intra-operative, and post-operative variables for all patients undergoing surgical microwave ablation. All patients who have a surgical microwave ablation with the Neuwave system will be added to the database after their treatment and procedures have been completed.
To prospectively collect and evaluate pre-operative, intra-operative, and post-operative variables for all patients undergoing surgical microwave ablation. All patients who have a surgical microwave ablation with the Neuwave system will be added to the database after their treatment and procedures have been completed. All data points will be collected from the electronic medical records (EMR) (office visit notes, operative notes, follow-up visits, CT scans, etc.). The collected data points will be utilized to study outcomes such as local/regional reoccurrences and distant occurrences related to hepatic tumor(s), whether there was complete destruction, residual disease/incomplete destruction, or recurrence at the ablation site. Overall-complications, length of stay, readmission rates, and any additional outcomes data that is relevant to MWA and improving surgical outcomes will also be collected. There are various Microwave Ablation (MWA) systems available that are utilized at the study locations to treat hepatic tumors. For this study, the focus is on subjects treated with the Certus 140TM system from NeuWave Medical®. Certus 140TM microwave generator possesses a 2.45 gigahertz (GHz) operating frequency and can power up to 140 watts. It can deliver microwave energy through three distinct channels simultaneously through a single system and uses three distinct antenna types (LK, SR, PR). It also contains a CO2-based cooling system that helps limit the temperature of the handle and cable. It is compatible with a variety of probes (LK, SR and PR antenna) and offers two modes, Ablation mode and Surgical mode. The Ablation mode is used for ablating a substantial target for several minutes until the object of the ablation is necrotic. Surgical Mode is used to ablate or coagulate a target for shorter periods of time while frequently moving the probe in a technique known as "planar coagulation." Current data and manufacturer guidelines for recommended ablation energy outputs for microwave ablation systems are obtained via ex vivo and animal models with tissues that exhibit different properties of energy transference than in vivo human tissues, particularly, human hepatic solid tumors. The objective is to prospectively assess the thermodynamics of microwave ablation energy in this context, specifically through the creation of power/time curves to predict future ablation volumes through single applications of MWA energy per lesion.
Study Type
OBSERVATIONAL
Enrollment
60
The NEUWAVE System supports target ablation or linear coagulation in surgical liver resection procedures. The System offers a versatile probe portfolio, multi-probe synchrony and CO2 cooling to help control the shape, size and burn pattern of your ablations.
Atrium Health
Charlotte, North Carolina, United States
Prospective Power/Time Analysis of In Vivo Laparoscopic Microwave Ablation Thermodynamics in Hepato-Pancreato-Biliary Sold Tumors Utilizing a Single Generator at a Single Surgical Center
The primary objective is to prospectively assess the thermodynamics of microwave ablation energy in this context, specifically through the creation of power/time curves to predict future ablation volumes through single applications of MWA energy per lesion.
Time frame: Year 2
Liver appearance
Investigator to describe the appearance of the liver intraoperatively
Time frame: Baseline
Presence of extrahepatic disease
Investigator to describe if any extrahepatic disease is present
Time frame: Baseline
Chronic Liver Disease Evidence
Investigator to describe if any chronic liver disease is present
Time frame: Baseline
Number of Lesions
Number of lesions present
Time frame: Baseline
Lesion location
Location (segment) of each lesion
Time frame: Baseline
Size of Lesion
Size of each lesion
Time frame: Baseline
Amount of Power used
Power (W) used to ablate each lesion
Time frame: Baseline
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Amount of Time used
Time (min) used to ablate each lesion
Time frame: Baseline
Distance between lesions
The distance between liver lesions
Time frame: Baseline
Ablation Dimensions
Ablation dimensions as assessed by post-operative cross-sectional imaging using the x-axis along the length of the antenna tract and y-axis perpendicular to the antenna tract
Time frame: day 90
Disease Recurrence Rate
Disease recurrence defined as the radiologic presence of disease present at the index location at the 4-week follow up postoperative cross-sectional imaging
Time frame: week 4
Number of New lesions
New lesions noted on CT (as above) and their measurements
Time frame: day 90
Radiographic liver appearance
Liver appearance on CT
Time frame: day 90
Radiographic extrahepatic disease
Presence of extrahepatic disease on CT
Time frame: day 90
Tumor measurement
Index tumor diameter and volume
Time frame: Baseline
Ablation Time
The time at which ablation occurred
Time frame: Baseline
Ablation Energy output
Energy output from ablation
Time frame: Baseline
Ablation Margins
Ablation margins
Time frame: day 90
Operative Time Amount
Time from first incision until final skin closure
Time frame: Baseline
Length of Stay
Time from hospital admission until hospital discharge
Time frame: up to 90 days
Readmission Rates
Percentage of patients who were readmitted to the hospital after MWA
Time frame: day 90
30 day complication rate
Percentage of patients who experienced a complication 30 following MWA
Time frame: day 30
90 day complication rate
Percentage of patients who experienced a complication 90 following MWA
Time frame: day 90