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Robot-Assisted Microwave Ablations of Liver Tumors: Is This the Beginning of a Paradigm Shift?

Narayanan G, Ruiz EM, Dijkstra M, van den Bemd BAT, Mahendra A, Ramasamy SK, Landinez GP, Schiro BJ et al.

Journal of vascular and interventional radiology : JVIR, 2026

78 participants

Abstract

PURPOSE: To evaluate the safety and accuracy of robot-assisted microwave ablation (MWA) for primary and secondary liver tumors using the Epione (Quantum Surgical, Montpellier, France) robotic system.

MATERIALS AND METHODS: This single-center retrospective study included all computed tomography (CT)-guided robotic MWA procedures performed at the Miami Cancer Institute, Baptist Health South Florida from May 2023 to March 2025. Primary endpoints were safety, assessed by adverse events related to robotic guidance or ablation, and accuracy, defined by the need for minor (depth/lateral) or major (antenna removal and reinsertion) adjustments. Secondary endpoints included feasibility, technical success, local tumor progression (LTP), LTP-free survival (LTPFS), and local control (LC).

RESULTS: A total of 153 robot-assisted antenna placements were performed to treat 152 tumors in 78 patients. Robotic placement was feasible in 98.7% (77/78) of patients. Technical success was achieved in 96.8% (152/157) of trajectories. Among all trajectories, 18.5% (29/157) required no adjustment, 62.4% (98/157) required minor depth adjustment, 17.8% (28/157) required minor lateral adjustment, and 3.2% (5/157) required major adjustment. Of major adjustments, 4 were corrected with robotic reinsertion, and 1 was corrected manually. Mean preadjustment lateral deviation was 5.6 mm (SD ±3.9). Adverse events occurred in 14.1% (11 Grade 1, 2 Grade 2, and 1 Grade 3) of procedures, none directly related to…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 78 participants or records.

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