DEMCON’S accurate needles

The standard therapy for the treatment of liver cancer is the surgical removal of the liver tumour. With this procedure, a lot of healthy liver tissue is necessarily also removed, because of the procedure’s complexity. An alternative method is the ablation (‘burning’) of the tumour with either radio or microwave radiation procedures. With this local therapy, the specialist will manually insert a needle through the skin into the tumour, with the help of imaging through a CT-scanner. This procedure’s advantages are that a large-scale surgery is not necessary and that hardly any healthy liver tissue is damaged in the procedure. Its disadvantage is the difficulty for a specialist to position the needle correctly in the tumour immediately. Usually it takes a number of actions: inserting the needle, making the CT-scan, inserting the needle once more in an adjusted orientation, etcetera, until the right position is found. It makes this procedure time consuming and burdensome for the patient. DEMCON has developed an innovative technology that makes this procedure both patient and specialist-friendly.

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Worldwide, dozens of solutions have been conceived to tackle this problem, from simple additional tools to a robot that can insert the needle fully automated. In practice, most specialist will still do this manually because these systems are either uneasy to use or are not adequate enough for the procedure. In a European research-project with partners such as Philips and Nucletron, DEMCON saw possibilities for an approach that will insert the needle correctly the first time as well as fitting the specialist’s workflow. In the development of that patient and specialist-friendly solution, DEMCON has partnered with the specialists of the University Medical Center Groningen and the Erasmus MC from Rotterdam.

As close as possible to the current workflow

The reference point was to stay as close to the current workflow and only automate a step in the procedure that is critical for the pace and result (‘first time right’) of the procedure. That critical step is to determine the angle under which the needles is inserted into the body. DEMCON developed a system that consists of a head with a needle guidance mechanism that can be placed around the patient manually, and an arm that can fixate the head with a single act in relation to the operating table. After the system, has been placed around the patient, it will enter the CT-scan together with the patient. It allows for the determination of the tumour inside the patient in relation to the head and subsequently, the system will automatically operate the needle guidance mechanism to guide it to the exact direction. Subsequently, the needle will be secured in the needle guidance mechanism and inserted into the body by the specialist. Maarten Arnolli is a Mechatronics Systems Engineer that has worked on the project:

 

“Our vision was to change as little as possible in the way a specialist places a needle currently and we only wanted to assist him with this single critical task. We first oriented ourselves on the current solutions and those attempts taught us what not to do. Then we continued to follow the current, manual workflow. The device does exactly what the user needs and nothing more. Being mechatronics we could, of course, added an actuator that would insert the needle. But we would rather leave this responsible task to the specialist, who is able to feel, while inserting, through which tissues the needle goes and when it has reached the tumour. Most specialists want to be able to do this form of control manually, which means that system doesn’t make any unnecessary infringements on the current workflow and responsibilities of the doctor. It means the system will be accepted more easily and faster and therefore this approach will directly make for a cost-effective system.”

 

Read more here about the extraordinary innovations by DEMCON! 

Date: 5 January 2017
Source of tekst: DEMCON
Author: Gravoche Abels
Audio / video: DEMCON