Recently, the team led by Director Zhang Guanglin at Huangshi Central Hospital used Wknife to complete two liver cancer ablation procedures with a single needle under local anesthesia.
Patient Overview
Case 1: Mr. L, male, 58 years old. On follow-up examination after ablation for hepatocellular carcinoma (HCC), a hepatic segment S3 nodule (approximately 34 × 25 mm) was found to have enlarged markedly compared with before, and tumor recurrence/metastasis was considered. The patient also had liver cirrhosis, splenomegaly, and lower esophageal varices, as well as a history of cholecystectomy. With limited hepatic functional reserve and a high risk for repeat surgery, a local treatment modality that was minimally invasive and had low impact on liver function was urgently needed.
Case 2: Mr. X, male, 74 years old, diagnosed with HCC more than 2 months earlier (CNLC stage Ib), with comorbid hypertension and alcoholic liver cirrhosis. Given his advanced age and the accumulation of underlying diseases, and his poor tolerance of surgical resection, local ablation was the more appropriate treatment option.
Both patients underwent multidisciplinary evaluation at Huangshi Central Hospital and were enrolled in the first Wknife trial in Hubei.
Procedure: Single Needle Under Local Anesthesia — Two Procedures Completed Smoothly
Both procedures were performed personally by the team led by Director Zhang Guanglin at Huangshi Central Hospital.
The first procedure fully demonstrated the core technical advantages of Wknife: it adopted a bipolar single-needle approach and was completed under local anesthesia, requiring no general anesthesia or muscle relaxant. During the procedure the patient had no obvious muscle twitching and no obvious pain or discomfort; vital signs remained stable throughout, and the procedure was completed smoothly. Immediate postoperative assessment showed satisfactory ablation results。
In the second procedure, Wknife ablation was performed on the intrahepatic lesion. Postoperative imaging comparison showed good coverage of the ablation zone, the patient’s vital signs were stable, and the patient returned safely to the ward.
It is worth noting that, as an operator using Wknife for the first time, Director Zhang Guanglin and his team easily completed liver cancer ablation, demonstrating that Wknife single-needle ablation under local anesthesia is simple to perform and has a short learning curve，accumulating cases for the large-scale promotion and use of irreversible electroporation (IRE) technology nationwide.
Director Zhang Guanglin gave full recognition to his first trial use of Wknife, noting that Wknife’s single-needle operation significantly simplified the needle placement workflow and greatly shortened the procedure time, that patient tolerance under the local anesthesia protocol was good, and that safety was also greatly improved; the overall experience of the two procedures was solid and reliable. At the same time, from the operator’s perspective, Director Zhang offered suggestions for further optimizing the device, expressing the hope that a domestically developed innovative device can be continuously refined and progressively improved through ongoing feedback from the clinical frontline.
First, the significance of local anesthesia: freeing ablation from the “anesthesia threshold.” Conventional irreversible electroporation (IRE) causes intense muscle contraction because of the pulses, and requires general anesthesia with deep muscle relaxation; many departments without anesthesia facilities and many patients at high anesthetic risk were therefore shut out. Wknife’s unique broad-spectrum synergistic technology does not trigger muscle contraction, so the procedure can be completed under local anesthesia. For patients, a local anesthesia protocol means lower risk and faster recovery; it also means that regional hospitals facing a shortage of anesthesia resources can likewise offer ablation.
Second, the significance of the single needle: turning a “master’s craft” into a “routine procedure.” Conventional IRE requires 2~6 monopolar needles arranged in a strictly parallel array, a procedure of extremely high difficulty that for a long time only experts at a handful of top-tier hospitals were able to handle. Wknife’s bipolar single needle integrates the positive and negative electrodes within a single needle, eliminating the need for a parallel array and greatly increasing the freedom of needle placement. That Director Zhang Guanglin’s team performed two consecutive procedures on the same day on their very first use, with both succeeding, is the most compelling proof: single-needle technology moves highly difficult ablation from “exclusive to top-tier hospitals” toward “reproducible at regional hospitals,” allowing quality ablation technology to truly reach the grassroots.
Third, the significance for indications: opening a door for more patients with “no way out.” Of the two patients in these procedures, one had recurrence after ablation with limited hepatic functional reserve, and the other was 74 years old with comorbid liver cirrhosis and hypertension — both belonging to the “high-risk group” for surgical resection and conventional treatments. The non-thermal, selective ablation characteristics of Wknife enable it to safely cover such patients with poor liver function and multiple comorbidities; as clinical experience accumulates across more anatomical sites and more disease types, the scenarios in which Wknife can be applied will continue to broaden, enriching the treatment choices between palliative care and curative treatment.
Expert Profile
Zhang Guanglin
Huangshi Central Hospital; Director of the Department of Hepatobiliary, Urologic, Gynecologic and Oncologic Surgery; Director of the Minimally Invasive Tumor Center; MD; Master’s Supervisor; Associate Professor
One of the Top Ten Discipline Leaders of the Huangshi Health System
Visiting Scholar, SCHWARZWALD-BAAR-KLINIKUM, Germany
Member, Focused Ultrasound Therapy Group, Minimally Invasive and Non-Invasive Committee, Chinese Medical Doctor Association
Member, Radioactive Seed Branch, Minimally Invasive Tumor Therapy Committee, Chinese Anti-Cancer Association
Member, Photodynamic Therapy Committee, Chinese Anti-Cancer Association
Member, Ablation Therapy Branch, Minimally Invasive Tumor Therapy Committee, Chinese Anti-Cancer Association
Member, Asian Society of Cryosurgery
Vice Chair, Tumor Biotherapy Committee, Hubei Society for Immunology
Standing Committee Member, Committee of Molecular Biology and Translational Medicine, Hubei Anti-Cancer Association
Member, Gynecologic Oncology Committee, Hubei Anti-Cancer Association;
Member, Colorectal Cancer Committee, Hubei Anti-Cancer Association;
Member, Liver Cancer Committee, Hubei Anti-Cancer Association
Member, Gastrointestinal Tumor Committee, Hubei Clinical Medicine Association
Vice Chair, Oncology Physicians Branch, Wuhan Medical Doctor Association;
Standing Committee Member, Oncology Committee, Huangshi Medical Association
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
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