Recently, President Niu Lizhi of Guangzhou Fuda Cancer Hospital successfully performed Wknife ablation for an 81-year-old patient with a huge pancreatic cancer, poor cardiopulmonary function, and postoperative recurrence patient.
This ablation procedure was completed with a single needle under local anesthesia and was the first Wknife pancreatic cancer ablation procedure in South China.
Patient Overview: Recurrence at Advanced Age — a Huge Tumor Brings Multiple Challenges
The patient treated this time was already 81 years old. He had previously undergone surgery for pancreatic cancer, with tumor recurrence after surgery and local progression after multiple courses of chemotherapy. Follow-up imaging showed a tumor measuring approximately 8.9 cm*4.2cm*9.5 cm, involving the area around the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery, as well as the proximal common hepatic artery — huge in volume with complex disease.
More challenging still, the patient had poor cardiopulmonary function and could not tolerate conventional surgery or other ablation treatments requiring general anesthesia.
How to achieve effective local control of a huge recurrent tumor in an elderly patient with poor cardiopulmonary function who could not tolerate endotracheal intubation under general anesthesia, all while ensuring the patient’s safety, became a severe test for the medical team.
Procedure: Single-Needle “Moving Ablation” Under Local Anesthesia Solves Three Major Problems in One Procedure
To overcome this challenge, after meticulous preoperative evaluation, President Niu Lizhi decided on a local palliative ablation strategy, using “local anesthesia” plus a “single-needle” Wknife moving ablation combined with nerve block, so as to control the local lesion, reduce tumor burden, and relieve the patient’s cancer pain while creating favorable conditions for subsequent systemic therapy.
The procedure was performed under local anesthesia; the patient remained awake throughout, and no muscle relaxant or endotracheal anesthesia was used, nor was ECG synchronization required.
President Niu first performed a precise preoperative biopsy to clarify the pathological nature of the disease, and also performed a nerve plexus block to relieve the patient’s pain. Under dual image guidance with ultrasound and CT, President Niuprecisely punctured the tumor target area with Wknife’s integrated bipolar single needle, advancing and withdrawing the needle at multiple angles and depths to ablate.
Immediate postoperative CT image review showed that the ablation zone exhibited typical vacuole-like changes, achieving the intended ablation goal.
Single needle inserted during the procedure
Immediate postoperative imaging
The entire procedure lasted less than one
hour, which not only reduced the physician’s operative workload
but also greatly reduced the cardiopulmonary burden on the elderly
patient.
Follow-up contrast-enhanced CT on the next day showed a significant ablation effect. (MRI could not be performed because of a metal stent.)
Postoperative contrast-enhanced CT imaging
In his postoperative review, President Niu Lizhi noted: "For complex pancreatic cancer patients who are elderly and have cardiopulmonary dysfunction, ablation under conventional general anesthesia carries extremely high risk. Conventional NanoKnife requires general anesthesia and muscle relaxation, which has a considerable impact on patients, causing many patients to lose the opportunity for NanoKnife treatment. The implementation of local-anesthesia NanoKnife is an important international breakthrough for NanoKnife and a source of pride for our domestic brand. Today, through the specifics of this first clinical case, we have further verified the feasibility, efficacy, and safety of Wknife’s ‘single needle–local anesthesia’ approach.
More importantly, in a single minimally invasive procedure we simultaneously completed biopsy confirmation, nerve plexus block for analgesia, and tumor ablation, which avoided the risks of general anesthesia, relieved to a certain extent the severe pain caused by pancreatic cancer, and greatly reduced the tumor burden while helping to improve the local tumor microenvironment. This treatment approach — trading minimal trauma for relatively large benefit — bought valuable time for subsequent comprehensive anti-tumor therapy and also improved the patient’s quality of life."
Existing clinical studies have shown that for unresectable pancreatic cancer, local ablation with IRE plus chemotherapy and immunotherapy can improve patient outcomes, enhancing quality of life and prolonging survival.
However, conventional IRE devices require multiple parallel needles placed under general anesthesia, and the entire needle placement process generally takes about an hour, placing extremely high demands on the operator’s procedural precision and spatial judgment; the number of physicians in China proficient in this technique is relatively limited. In addition, because some patients cannot tolerate general anesthesia and because multiple needles are costly, most hospitals find it difficult to achieve routine, large-scale application after purchasing the equipment.
The domestically developed innovative medical device — Wknife — has achieved effective ablation globally with local anesthesia plus a single needle; combined with the clinical strategies of Chinese physicians, it makes pancreatic cancer ablation safer, simpler, and more affordable, bringing new hope to more patients with complex tumors who have lost the opportunity for conventional surgery.
Expert Profile
Niu Lizhi
Chief Physician, MD, PhD, Doctoral Supervisor, President
He received his PhD in thoracic surgery from the Fourth Military Medical University and is currently President of Guangzhou Fuda Cancer Hospital. He also serves as President of the 23rd International Society of Cryosurgery, Vice President of the Asian Society of Cryosurgery, and Chief Expert of the Fuda International Cryotherapy Center and NanoKnife Treatment Center. He has published more than 300 papers, including 81 SCI articles. He has also participated in the authorship of more than 20 medical monographs, served as editor-in-chief of three, and held a total of 25 research grants.
He specializes in tumor surgery and minimally invasive cryotherapy and NanoKnife treatment, and is uniquely accomplished in the minimally invasive treatment of solid tumors such as pancreatic cancer, liver cancer, lung cancer, and kidney cancer. He has led his cryotherapy team in completing many cases (more than 10,000) of complex minimally invasive cryotherapy, treating patients ranging in age from a 4-year-old child to a 94-year-old, from foreign ministers of health and celebrities to ordinary citizens, all with satisfactory outcomes.
About winonco
Hangzhou winonco Medical Technology Co., Ltd. focuses on the field of minimally invasive tumor ablation and is a National High-Tech Enterprise that is oriented to clinical needs and drives the R&D of innovative medical technologies. With fully self-developed high-voltage pulsed electric field irreversible electroporation (IRE) technology at its core and covering a multi-physics, multi-modal technology platform, the company develops internationally leading minimally invasive tumor ablation solutions.
The company was founded by scientists who returned from Europe and the United States and by international-level talent scientists, and it has a high-level multidisciplinary R&D team integrating electrical engineering, biology, medicine, and clinical practice. Leveraging its internationally leading steep pulse ablation technology platform and systematic solutions oriented to clinical needs, it has received funding from a Key Program of the National Natural Science Foundation of China in this field as well as multiple national key R&D and NSFC grants. The company holds fully independent intellectual property rights to IRE technology and has cumulatively filed more than 200 domestic and international invention patents (including 18 PCT applications). The company will continue to drive technological innovation and clinical translation, providing patients worldwide with safer, less invasive, and more accessible Chinese solutions.
Official website: www.winonco.com
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