Video assisted thoracoscopic microwave coagulation therapy (VATMCT) for a liver tumor

Abstract

Microwave coagulation therapy (MCT) induces tumor coagulation, and is now recognized as an efficient treatment for hepatocellular carcinoma or metastatic tumor of the liver, with equivalent results to hepatic resection. However, when the tumor is located just below the top of the diaphragmatic dome, MCT via laparotomy requires a large incision, and percutaneous MCT is sometimes impossible because of the technical limitation of ultrasound known as ‘dead’ space. To perform MCT for a liver tumor arising just below the top of the diaphragmatic dome in a safe and less invasive manner, a procedure of MCT using a thoracoscope (thoracoscopic transdiaphragmatic MCT) has been reported. However, the skill to perform thoracoscopic surgery and special devices are essential for this technique. An adission of mini-thoracotomy just above the site of the tumor ought to make it easy to perform MCT in these cases. We performed MCT for 7 cases with liver tumors located just below the top of the diaphragmatic dome using thoracoscopic-assisted procedure with a mini-thoracotomy (video assisted thoracoscopic MCT, VATMCT). Here we present this technique and our preliminary results.