2023 Volume 60 Issue 5 Pages 297-300
In the context of particle therapy for malignant abdominal tumors, the significant challenge of radiation-induced damage to the gastrointestinal tract in close proximity to the tumor hinders the effective delivery of a curative dose. To address this limitation, a spacer implantation technique was developed at Kobe University. This technique involves inserting an ePTFE sheet between the tumor and the gastrointestinal tract during laparotomy as preparation for particle irradiation. It has successfully treated over 200 patients with malignant abdominal tumors between August 2006 and March 2022. Furthermore, our research efforts led to the development of a non-woven absorbable spacer, resulting in the launch of NESKEEP®. From June 2019 to March 2022, more than 50 cases have been performed utilizing NESKEEP®. The NESKEEP® offers advantages due to its enhanced flexibility compared to ePTFE sheets, facilitating easy disassembly, connection, and shaping to fit the tumor, securing it between the tumor and organ. The absorbable nature of the material also expands the use of NESKEEP®, potentially aiding in complicated resections of the gastrointestinal tract and infections. This presentation aims to provide an overview of the surgical techniques employed in NESKEEP® implantation and discuss future issues in absorbable spacer implantation, including its application to pediatric patients.
