Recently, the team led by President Niu Lizhi at Guangzhou Fuda Cancer Hospital successfully completed world’s first Wknife ablation of an adrenal gland metastatic lesion of lung cancer。
Patient Overview: History of Coronary Heart Disease Combined with Dual Metastases
The patient, Mr. Li, male, 64 years old, was diagnosed with a malignant lung tumor and had successively received systemic chemotherapy combined with immunotherapy, one session of pulmonary cryoablation, and one session of pulmonary interventional chemotherapy. Recent imaging showed two metastatic lesions, in the pancreatic tail and the left adrenal gland (ultrasound showed a hypoechoic nodule approximately 15 × 11 mm in the pancreatic tail). The patient’s baseline condition was complex: comorbid coronary atherosclerotic heart disease, prior vascular stent implantation, and myelosuppression, making it difficult for him to tolerate highly traumatic surgical resection or aggressive treatment regimens.
The adrenal gland lies deep in the retroperitoneum, adjacent to the kidney, major blood vessels, and pancreas, with an extremely narrow operating space; the pancreatic tail lesion was similarly buried deep in the “crevice” between abdominal organs. Both lesions lay in “high-risk zones” that conventional ablation approaches struggle to cover safely.
After multidisciplinary evaluation, the team led by President Niu Lizhi decided to use Wknife’s bipolar single-needle (integrated bipolar single needle) technology to perform palliative ablation for the patient.
Procedure: Two-Needle Coordination — Two Lesions Conquered in One Hour
Because of the patient’s special circumstances, part of the treatment required the prone position with needle insertion via the back. The entire procedure was performed under CT image guidance. In view of the anatomical characteristics of the two lesions, the team placed two integrated bipolar single needles into each metastatic lesion — each needle itself integrates the positive and negative electrodes, and the two needles can be flexibly combined to discharge in pairs, offering far greater freedom of needle placement than conventional monopolar needle application.
Immediate postoperative assessment showed that the ablation zones covered both lesions adequately, with notable ablation results, and the patient returned safely. The Wknife ablation treatment took approximately 1 hour (including the time for puncture localization and position changes).
Preoperative imaging
Single-Needle Ablation of the Adrenal Lesion
Single-Needle Ablation of the Pancreatic Lesion
After the procedure, President Niu Lizhi commented: “After multiple courses of treatment, this patient still had two residual metastatic lesions, in the pancreas and the left adrenal gland. The anatomical location of these two nodules was extremely narrow and awkward; with conventional parallel placement of monopolar needles, the procedure would have been extremely difficult, or even impossible to perform. We used bipolar single-needle technology to simplify the complex — while simplifying the operation and improving safety, it reduced injury to nerves and blood vessels and also ensured effective lesion ablation.”
The adrenal gland is one of the common target organs for distant metastasis of solid tumors such as lung cancer and kidney cancer. However, compared with liver and lung metastases, adrenal metastatic tumors have long lacked mature and safe local treatment options, and the fundamental reason lies in anatomical constraints: the adrenal gland lies deep in the retroperitoneal space, immediately adjacent to the ipsilateral kidney, the inferior vena cava, or the abdominal aorta, and the surrounding operating space is extremely limited. Surgical resection is highly traumatic, and perioperative risk rises markedly with the burden of underlying disease (such as the coronary atherosclerotic heart disease and myelosuppression in this case); conventional IRE devices rely on multiple monopolar needles placed in a parallel array, which is difficult to perform safely within such a narrow anatomical space. Together, these factors constituted a long-standing technological gap in the field of local treatment for adrenal metastatic tumors.
This procedure validated the feasibility of Wknife combined with its “integrated bipolar single needle” within this anatomical forbidden zone: each needle itself integrates the positive and negative electrodes, and two needles can further be combined to discharge in pairs, balancing ablation coverage with flexibility of needle placement space. This makes it possible to achieve effective ablation with fewer puncture needles and a simplified path even within the narrow anatomical regions — such as the adrenal gland and pancreatic tail — where conventional IRE technology is difficult to apply, providing a new technical reference for this field.
This patient, who had comorbid cardiovascular disease and myelosuppression and who could not tolerate surgery or aggressive systemic therapy, represents a typical population with limited local treatment options. This “single procedure, simultaneous treatment of two metastatic lesions” achieved simultaneous local control of multiple metastases with relatively manageable procedure duration and degree of trauma, buying a time window for the subsequent systemic treatment regimen and reducing the cumulative risk to the patient of repeatedly undergoing invasive procedures because of underlying disease.
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. is a National High-Tech Enterprise whose mission is to deliver innovative minimally invasive tumor ablation solutions. 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 national-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), and it has twice been granted recognition under the Medical Device Innovation Channel. The company will continue to drive technological innovation and clinical translation, providing patients worldwide with safer, more reliable, less invasive, and more accessible Chinese oncology solutions.
Official website: www.winonco.com
Copyright © Hangzhou Winonco Medical Technology Co., Ltd. All Rights Reserved. Web design
