Laparoscopic thermal ablation therapy for hepatocellular carcinoma with forward-viewing laparoscopic ultrasonography (End-Fire array)

Laparoscopic thermal ablation for hepatocellular carcinoma (HCC) is thought to be more accurate technique than percutaneous ablation, because HCC can be treated under direct vision. However, it is difficult to puncture deep-seated whepatic tumors under standard linear-type laparoscopic ultrasonography. Forward-viewing laparoscopic ultrasonography (End-Fire array), which was recently been developed, enables us to puncture deep-seated HCC exactly. We have performed laparoscopic thermal ablation for 8 HCCs out of 7 patients by using this End-Fire array. Among them, three were treated by microwave coagulation and four were by radiofrequency ablation. Six of 7 patients were completely and easily treated with this array. One patient had multiple HCCs and two relatively large HCCs were ablated for mass reduction. Thus, this new array is useful to perform laparoscopic thermal ablation against deep-seated HCC.