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Ablative therapies in oncology surgery Fernando Burdío

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Hepatic ablation using radiofrequency

In recent years, radiofrequency (RF) ablation has become a promising, minimally invasive therapy for treating malignant liver tumours. However, the limited volume of ablation possible, in addition to the predictability and adaptation to a particular tumour, is still an obstacle hindering the wider application of this therapy. We have developed a new electrode (Gnomon) that incorporates a unique internal cooling system and a hypersaline solution infusion system.

This device should prevent the saline solution boiling, the tissue carbonising, and improve the electrical conductivity, leading to larger and more predictable ablations that better match the geometry of the tumour. We have recently completed a clinical trial with 70 patients in the Hospital del Mar (http://www.isrctn.com/ISRCTN73194360) aimed at evaluating the effectiveness of radiofrequency ablation using this device and microwave thermal ablation in the treatment of liver tumours. .

gnomon

Figura 1. Diagram of the hybrid applicator that includes an internally cooled electrode and two small diameter expandable tubes for perfusing hypertonic saline (20% NaCl) into the tissue at 6 mL/h.

aplicador hibrido

Figura 2. Computational analysis (Finite Element Model) of the temperature reached in the tissue at the end of the ablation in a conventional internally cooled ablation system (A) and in our ablation system (B). The green (around 50°C) shows the estimated volume of the final ablation. In our ablation system (B), hypersaline solution is introduced to improve the shape and size of the ablation, making it larger and more spherical. 

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