title: Initial experiences with MR Image-guided laparoscopic microwave coagulation therapy for hepatic tumors.
abstract: OBJECTIVE
  Percutaneous thermal ablation is used for treating hepatic tumors. Recent advances in laparoscopy and imaging modalities have led to the development of a novel image-guided minimally invasive loco-regional treatment. The aim of this trial was to apply laparoscopic assistance to magnetic resonance (MR) image-guided thermoablation instead of ultrasonography, because of its various advantages.
  
  
  METHODS
  Patients with hepatic tumors and liver cirrhosis underwent magnetic resonance (MR) image-guided laparoscopic microwave coagulation therapy using a borescope and endoscopic forceps. Six cases of laparoscopic microwave coagulation treatment using MR image guidance were successfully performed between January 2000 and December 2008. Tumors were detected, punctured, and ablated in an open-configured MR scanner. A total of nine hepatocellular carcinoma nodules were preoperatively identified in S3, S5 and S6 (mean diameter = 20.8 ± 5.4 mm).
  
  
  RESULTS
  MR-guided microwave coagulation was laparoscopically achieved in all patients without any significant complications that required invasive treatment. The mean length of the operation was 275.3 ± 60.5 min, and the mean postsurgical hospital stay was 10.0 ± 2.3 days. Postoperative confirmation scanning was performed without moving the patients.
  
  
  CONCLUSIONS
  MR-guided laparoscopic microwave coagulation therapy is an effective treatment for hepatic tumors adjacent to other organs, as it allows for more accurate detection of lesions and for tumors to be treated safely while avoiding adjacent organs. It is less invasive than conventional procedures, because the MR real-time guidance enabled continuous monitoring throughout the procedure.
authors.affiliation: Biomedical Innovation Centre, Shiga University of Medical Science, Seta Tsukinowa-cho, Ōtsu, Shiga, 502-2121, Japan, emkami@belle.shiga-med.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Murakami
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Naka
authors.forename: Hisanori
authors.initials: H
authors.lastname: Shiomi
authors.forename: Hiroya
authors.initials: H
authors.lastname: Akabori
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kurumi
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Morikawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D061646:Operative Time; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome