Adapting to a Robotic Workstation for Image-Guided Liver Cancer Surgery

CancerNetwork® spoke with Govindarajan Narayanan, MD about his practice becoming the first in the United States to successfully surgically treat a patient with a liver tumor using the Epione robot, as well as the process of transitioning from CT-based image guidance to the robotic workstation in his care.1 

Narayanan, a professor of Radiology and an interventional radiologist at Miami Cardiac and Vascular Institute and the chief of Interventional Oncology at Miami Cancer Institute, both of Baptist Health South Florida, described how the use of Epione may save significant amounts of time while performing microwave ablation, cryoablation, and irreversible electroporation (IRE). Developers designed the robotic device to simplify several probe procedures, helping make large tumors more predictable to manage.2 

According to Narayanan, Epione is suitable for use in any patient for whom his practice typically performs image-guided ablations. Additionally, the device may “level the playing field” by allowing those with less experience to give highly accurate surgery, thereby increasing the availability of physicians who can offer these treatments across multiple practices.

Narayanan also described some of the potential challenges associated with adopting the Epione robot in clinic, such as adapting to the physical space that it occupies in the operating room. The device may also pose a steep learning curve with respect to procedures involving multiple needles such as cryoablation and IRE, as it is necessary to set a path that won’t cause any deflections of the needle. 

Looking ahead, Narayanan said that future technological developments may allow users to operate the robot remotely, allowing patients to receive surgery at a treatment center even if a practicing physician is not physically present.

“It’s very exciting to be at the forefront of bringing such a cutting-edge technology to mainstream clinical practice,” Narayanan said. “Everything is done with one click, so it saves a significant amount of time. And because you’re not doing multiple check scans when you place the needles, you’re saving on radiation time.”

References

1.     First patient treated in the United States with Quantum Surgical’s Epione® robot. News release. Quantum Surgical. May 24, 2023. Accessed November 6, 2023. https://shorturl.at/lzH01

2.     Epione. Quantum Surgical. Accessed November 7, 2023. https://shorturl.at/dqyL6