The Medical City Pioneers Innovative Tumor-Debulking Procedure in the Philippines

By The Medical City (TMC), Ortigas | August 01, 2023

The Medical City made history in the field of medical innovation by successfully performing a case of tumor-debulking using percutaneous ultrasound-guided thermal ablation, specifically Microwave Ablation.

Pasig City – On July 8, 2023, The Medical City made history in the field of medical innovation by successfully performing a case of tumor-debulking using percutaneous ultrasound-guided thermal ablation, specifically Microwave Ablation. This breakthrough procedure, conducted by the Section of Head and Neck Surgery of TMC's Department of Surgery, establishes TMC as the first tertiary hospital in the Philippines to offer this advanced technique using the ECO BASEMED Microwave Ablation Machine.

The team, led by Dr. Rainer Yu Lutanco and supported by Dr. Michael Jeff B. Fontano, Dr. Christelle Anne M. Almanon, and Dr. Gracielle Mia Banares, utilized an innovative approach to tumor-debulking. This approach involves the use of an electromagnetic field that induces cellular death through coagulative necrosis via dipole and ionic mechanisms.

The patient, a 64-year-old male with unresectable Thyroid Cancer, is stricken with cancer that has completely encased the carotid arteries and has partially blocked the upper airway, resulting in difficulty breathing. Traditional treatment methods would involve trying to remove as much cancer tissue as possible to relieve the strangulation effect of the tumor. However, this technique is known to have significant complication rates and is a recognized high-blood loss procedure. Therefore, with the use of the Ablation Machine, the Section of Head and Neck Surgery was able to achieve the desired outcomes through percutaneous methods, resulting in a safer and overall more effective treatment strategy.

While the microwave ablation technique has already gained worldwide recognition as a safe and effective method for managing tumors amenable to ablation, in the Head and Neck, this procedure is more commonly used for non-cancerous thyroid nodules. The procedure performed at The Medical City was the first to make use of this technology for metastatic, unresectable thyroid cancer in the country.

As demonstrated by the procedure performed at TMC, image-guided thermal ablation offers several advantages, such as faster recovery time, lesser blood loss, reduced morbidity and mortality rates, accurate targeting enabled by ultrasound image guidance, lower procedural cost, and daycare treatments resulting in reduced hospital stay, with short-term studies showing superior outcomes to conventional techniques.

"Through this minimally invasive technique, patients at our section can benefit from more accurate and precise procedures," Dr. Lutanco said.

The ablation was performed under general anesthesia due to the nature of the disease blocking the patient's airway. The microwave antenna was placed under image guidance, utilizing ultrasound to ensure proper localization and placement. The antenna was positioned within the lesion, and the power and time of energy delivery were adjusted to ensure the ablation covered not only the entire lesion but also a centimeter of normal

parenchyma surrounding the lesion (A0 ablation). Hydrodissection was employed to protect nearby structures and prevent inadvertent thermal injury. The adequacy of ablation was assessed through overlapping ablation techniques and confirmed using post-ablation ultrasound.

The Department of Surgery at The Medical City is a world-class facility managed by a team of internationally trained and renowned surgeons, hepatologists, radiologists, oncologists, pediatricians, and intensivists. Within the department, the Section of Head and Neck Surgery offers a wide range of diagnostic, therapeutic, medical, surgical, and radiologic services for head and neck conditions. Patients can expect comprehensive care from a team of experts utilizing the latest techniques and technology.

With its successful implementation of percutaneous ultrasound-guided thermal ablation, TMC proves its commitment to innovation in healthcare, cementing its status as a leading institution in the medical field.