137 - Robotic Assisted Microwave Ablations of Liver Tumors – a Paradigm Shift

Monday, April 13, 2026

4:12 PM - 4:21 PM ET

Presenting Author(s)

Govindarajan Narayanan, MD, FSIR

Professor and Interventional Radiologist
Miami Cardiac & Vascular Institute, United States

Author/Co-author(s)

ER

Elizabeth Ruiz, BA

Bsc
Florida International University, Miami, FL, USA, United States
Bv

Bente van den Bemd, MD

PhD Candidate
Department of Interventional Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA., United States
MD

Madelon Dijkstra, MD

Research associate
Miami cancer institute, United States
Ripal Gandhi, MD, FSIR

Professor
Miami Cardiac & Vascular Institute, Miami Cancer Institute, United States
Brian J. Schiro, MD

Vascular and Interventional Radiologist
Miami Cardiac & Vascular Institute / Radiology Associates of South Florida, United States
Gina Landinez, MD (she/her/hers)

IR Faculty
Miami Cardiac and Vascular Institute (MCVI) Miami Cancer Institute (MCI), United States
Constantino Pena, MD

Interventional Radiologist
Miami Cardiac & Vascular Institute, United States
Sv

Susan van der Lei, MD, PhD

MD, PhD Candidate
Department of Interventional Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA., United States

Purpose: To evaluate safety and accuracy of robotic-assisted microwave ablation (MWA) for primary and secondary liver tumors using the Epione^TM (Quantum Surgical) robotic system.

Materials and Methods: This single-center retrospective study included CT-guided robotic MWA procedures in 78 patients between May 2023 and March 2025. Primary endpoints were safety and accuracy. Safety was assessed by reporting adverse events related to robotic guidance and the ablation procedures. Accuracy was assessed by minor (depth or lateral) and major (antenna reinsertion) adjustments. Secondary endpoints included feasibility, technical success, local tumor progression (LTP), LTP-free survival (LTPFS), and local control (LC).

Results: Robotic placement was feasible in 77 of 78 patients (98.7%). Technical success per-trajectory was 99.4% (156/157). Antenna placement was successful after the first insertion in 96.8% (152/157) of trajectories; 18.5% needed no adjustments. Minor corrections were made in 80.3% (62.4% depth, 17.8% lateral); 3.2% (5/157) required reinsertion. One antenna was started with robotic guidance and ultimately placed manually. Mean pre-adjustment lateral deviation was 5.6 mm (SD 3.9). Adverse events occurred in 14.1% of procedures (11 grade 1, 2 grade 2, 1 grade 3), none related to robotic deviations. At a median of 6.9 month follow-up, LTP occurred in 9.2% (14/152 tumors). One- and two-year per-tumor LTPFS was 87.3% and 84.7%; LC was 100%. LTP decreased from 13.2% in year one to 3.3% in year two of robotic guidance.

Conclusion: Robotic guidance for liver MWA demonstrated a high safety profile and feasibility, excellent technical success, and low placement error with no robot-related complications supporting its safety and accuracy in clinical practice.