The University Hospital of Innsbruck reports on a “worldwide unique procedure”: for the first time, a leak in the largest lymphatic vessel in a patient’s body was treated with a microrobot-assisted puncture and vessel closure. The affected patient (63) was discharged just 48 hours after the procedure.
The traditional, normal approach would have been to subject the patient to major surgery, possibly involving opening the chest to stop the leak.
Minimally invasive access instead of serious surgery
The 63-year-old, who had to have most of his esophagus removed due to cancer, was still recovering from his first major surgery, so two experts from the University Hospital of Radiology wanted to spare him another operation and decided on a “worldwide operation” with a unique, robotic and minimally invasive access.
Life-threatening leak in barrel
A leak in the body’s largest lymphatic vessel (the thoracic duct) had caused about a liter of lymph fluid to build up in the chest cavity every day, which would have been life-threatening in the long term, the difficult initial situation was described. “We first punctured a lymph node in each groin to introduce contrast medium into the patient’s lymphatic system,” chief physician Alexander Loizides explained.
In this way, the lymphatic vessel and the leak in it in the thoracic cavity could be visualized using imaging. The patient was then placed on his stomach to insert a long needle over his back into the large lymphatic vessel using robotic navigation.
Apparently not an easy undertaking, because on the way to the center of the body no sensitive blood vessels or organs may be injured and the very narrow target must be hit successfully, as the leading physician of the University Clinic for Radiology, Gerlig Widmann, explained: “And we have this all over the world. For the first time, a microrobot was used to support us in this task.”
“Very impressive”
Then a hollow guide catheter was inserted over the needle and maneuvered into the leaking lymphatic vessel. Eleven “spirals” (a kind of metal spiral, note) were inserted and the lymphatic vessel was completely sealed from the inside. “It was very impressive to see how within 24 hours no more fluid was added, how the patient could breathe normally again and was discharged after only 48 hours,” Widmann and Loizides say happily.
Source: Krone
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