THERMAL ABLATION TATO SYSTEM Laura Sarti Product Specialist 1 - - PowerPoint PPT Presentation

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THERMAL ABLATION TATO SYSTEM Laura Sarti Product Specialist 1 - - PowerPoint PPT Presentation

Mar 03, 2024 47 likes •550 views

THERMAL ABLATION TATO SYSTEM Laura Sarti Product Specialist 1 Definition Thermal Ablation (TA) is the use of extreme hiperthermic temperatures to destroy diseased tissues. T.A. is performed in Interventional Radiology as an alternative to the

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THERMAL ABLATION TATO SYSTEM

Laura Sarti Product Specialist

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Definition

Thermal Ablation (TA) is the use of extreme hiperthermic temperatures to destroy diseased tissues. T.A. is performed in Interventional Radiology as an alternative to the surgical treatment of tumors in:

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Different TA technologies

  • Radiofrequency
  • Microwaves
  • Laser
  • Cryoablation

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RF Current Flow

  • RF Currents that goes through the tissue from the tip of

the applicator to the ground pad. Side effect: skin burning.

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MW Energy

Microwaves radiate only near the tip of the applicator. An applied MW field causes water molecules to rotate bilions of time per second , which leads to heat generation.

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Comparison between RF and MW thermal ablation

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  • Heat sink effect
  • Ground pad required
  • Difficult to control the increase
  • f ablation
  • Less influenced by veins
  • Ground pad is not required
  • Predictable and controllable ablation
  • Compatible with pacemaker
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TATO : Multiprobe microwave thermal ablation System

  • Rev. 09 del 27.10.2016
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Main features of the system

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  • No cooling system

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  • Ergonomic and easily

transportable

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  • Multi-probes with detachable

cable

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  • 1. No cooling system

The NIC (Not Internally Cooled) coax needles have a high energy efficiency that allows operating with less MW power for treatment up to 15 minutes.

Cooling system not needed

Less complexity Higher reliability Greater safety Better applicator handling Reducing procedure dead time Easy control of the procedure

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Switch Unit Roll Stand

2.Ergonomic and easily transportable

Main Unit- Microwave generator Articulated Arm extendable up to 1,5 m

Tato cart version Tato travel version

Switch Unit Roll Stand

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Main unit

Handle On/off button Touchscreen 7,1 inch Yellow Led: lighting indicates that MWs are ON Red Led: when lighting up, it indicates a fault 2,45 GHz 120 W total power IEC standards compliant USB port

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Extendable arm and switch cover

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Extendable up to 1.5 m Sterile cover for arm

  • Total power 120 W
  • 1 to 4 power outputs
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TATO1 vs TATO2

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FEATURE TURES TATO1 O1 TATO2 O2 TOTAL POWER 100W 120W DATA LOGGING  DATA DOWNLOAD  TRACK ABLATION PROTOCOL  REFLECTED POWER MONITORING  SELECTION NEEDLE GAUGE 

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11 G 14 G 17 G 18 G

Multi-Gauge

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DIAMETER G mm 3 mm 2,1 mm 1,5 mm 1,2 mm

11 G 14 G 17 G 18 G

The thinnest applicator currently available in the world market

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Version with infusion tip

Holes 0,3 mm Ø

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  • 14 G and 17 G version
  • Applicator with 4 micro-holes in the tip for fluid infusion
  • A syringe can be used to inject fluids during the treatment
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  • Simple radiating monopole
  • High efficiency
  • Lightweight

(~35g w/o cable, 50g w/cable)

  • Detachable feeding cable:

advantage under CT scan

Main structural features

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Massa - Patient with HCC

 Usability of TATO under CT-scan  Extendable arm

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Echogenic needle

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Video of needle insertion

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  • All steel tips are tested with an applied force of 5kg.
  • No fragile ceramic parts are used
  • All probes are Teflon covered, non-sticky.
  • Available in different lengths from 10 up to 50 cm.
  • Centimeter marked cannula

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Main structural features

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How to insert the needle

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Lesion Ablation

E

Insert the tip of the needle into the lesion and use length E parameter (indicated in the chart) as reference.

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Control of increasing ablation volume : By employing lower MW power, the procedure’ s safety is increased, thus eliminating a lot of bubble gas and ensuring a better control under ultrasound. Gauge ge Max power er W 11 11 60 14 14 40 17 17 30 18 18 15

Main functional features

In order to operate safely, antennas must be used respecting the assigned power limits:

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Increasing ablation

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TATO 2 HMI

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TATO2 HMI Home Screen

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Setting

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Language Date and time LOG Download Services

Output mating cycles : 1 4 3 2

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TATO2 Home Screen

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Possibility to insert Patient ID, Physician ID and note

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Needle choice

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Therapy Setting

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Therapy summary

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Therapy running

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REFLECTED POWER COEFFICIENT OK : NEEDLE IS WORKING WELL AIR : NEEDLE IS IN THE AIR MISMATCH : NON-OPTIMAL FUNCTIONING OF NEEDLE NOT CONNECTED : NEDDLE IS NOT CONNECTED

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Therapy ended - Summary

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TRACK ABLATION

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Track Ablation

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Video for Track ablation

  • 14 G, 60 W, 25 sec

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Ex – vivo and in – vivo charts

  • f Tato System

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CHARTS TATO2

38 ABLATION ZONE EXAMPLES* – 1 APPLICATOR Ex – vivo Bovine Liver

11 G 60 W Duration (min) 10:00 15:00 L (cm) 6,0 7,0 D( cm) 4,3 5,0 E (cm) 1,3 1,5 14 G 40 W Duration (min) 5:00 10:00 15:00 L (cm) 5,0 5,4 6,2 D( cm) 2,6 4,0 4,5 E (cm) 0,9 1,0 1,1 17 G 30 W Duration (min) 5:00 10:00 15:00 L (cm) 4,6 5,0 5,6 D( cm) 2,5 3,4 3,8 E (cm) 0,8 1,0 1,2 18 G 10 W 15 W Duration (min) 5:00 10:00 5:00 10:00 L (cm) 2,0 2,6 2,3 3,3 D( cm) 1,4 1,7 1,5 2,3 E (cm) 0,4 0,6 0,6 0,6

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CHARTS TATO2

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CHARTS TATO2

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CHARTS TATO2

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E.g. HCC or liver metastasis

  • Examples of MW applications in different liver tumors with

same values of watt and time.

  • HCC : «oven effect» due to the tissue’s consistency that is rich

in water and to the encapsulated tumor’s morphology . The result is a bigger ablation.

  • Metastasis: no «oven effect» because of the tissue has less

water content and is not encapsulated. The result is a smaller ablation.

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Frequently used parameters

In vivo most frequently used values of power (W) and time (min)

  • D = diameter

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Diamet eter er

  • f tumor

0,5 <D<1 1<D<2 2<D<2,8 2,8 <D<4 D>4 Gauge 11 11 60 60 W Open surgery

1 needle 10 min 2 needles 15 min

14 14 40 40 W

1 needle 10 min 1 needle 15 min 2 needles 15 min 3 needles 15min 4 needles 10 min

17 17 30 30 W

1 needle 10 min 2 needles 15 min

18 18 15W 15W

1 needle 10 min

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Microwave ablation system Cross- reference

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Padova – TATO use in laparoscopy

  • Lesion: 7 cm
  • 2 x 14 G, 35 W, 15 min
  • And Repositioning 1 x 14G, 35 W, 4.5 min

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Treatment on HCC (percutaneous)

Dimension of the tumor 5 X 3 cm Used 2 x 17G

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Padova – Open surgery

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9 tumors in total RESECTION AND ABLATION

Data of the first 4 ablations: 18 mm, 35W, 10min 19 mm, 35W, 2.3min and 40W, 1.30min 20 mm, 40W, 6min 18 mm, 40W, 6.2min

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Osteoid osteoma

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Osteoid osteoma in vertebra

18G, 10W, 6min

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Aarau - Patient with kidney tumor Multi-probe case

Tumor size: 2.4 x 2.2 cm (+2 cm margin) Number of antennas: 4 x 14G Power: 100W total Time: 15min

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