Info

Laparoscopic

11/11

Abbreviation: VHL, von Hippel-Lindau.

Abbreviation: VHL, von Hippel-Lindau.

theoretical advantages of HIFU have yet to be translated into clinical results due to a large number of technological and logistic problems that, to date, have not been solved. The time required to reach ablative temperatures can be up to 20 minutes, even under ideal circumstances. Because the patient and the transducer are not coupled together, any movement over that time period can result in the dispersal of the energy into nontarget tissues. This can result in incomplete ablations or the ablation of nontarget tissues. Respiratory motion alone can be enough to interfere with accurate ablation. Another limitation is that the tissues do not change their imaging appearance during treatment, making monitoring of the ablation and assessment of response to treatment essentially impossible (84). Despite these limitations, Kohrmann et al. used HIFU to successfully ablate two of three renal tumors without significant complications (85). There is active research into solving these and other problems, using respiratory gating and computer-guided targeting systems. If significant improvements are made, HIFU will become an appealing ablation modality because of its noninvasive nature. However, a reliable commercial product is not yet available.

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