On July 24, 2024, the interventional team from Department of Gastroenterology of the First Affiliated Hospital (FAH) of Xi’an Jiaotong University (XJTU) successfully performed magnet-navigated transjugular intrahepatic portosystemic shunt (TIPS) for a patient with recurrent gastrointestinal bleeding due to liver cirrhosis. Under the guidance of Professor Xue Hui and with intimate cooperation of electromagnetic navigation engineer, the operation was successfully carried out by Deputy Chief Physician Li Weizhi and Attending Physician Ma Fuquan from Department of Gastroenterology. During the operation, the electromagnetic navigation images were fused with the ultrasound images by using the electromagnetic positioning puncture guide equipment of Medis Ultrasound, the position and status of the tips of TIPS puncture needles were real-time tracked, the distance and spatial position between the tip and the portal vein target were displayed in a real-time pattern, the puncture needle could be guided to penetrate into the target portal vein branch accurately and rapidly, and the portal shunt channel was rapidly established.

TIPS is a comprehensive interventional technique to control and prevent esophageal and gastric varices bleeding, promote ascites absorption and delay the progression of portal vein thrombosis by establishing an artificial shunt channel between the liver (or inferior vena cava) vein and the main branches of portal vein, and maintaining the long-term patency with metal stents. It has been widely applied in the control and prevention of variceal bleeding in liver cirrhosis, mitigation of intractable hydrothorax and ascites, control and alleviation of portal vein thrombosis, treatment of Budd-Chiari syndrome and hepatic sinus obstruction syndrome, and bridge treatment before liver transplantation. In recent years, with the update of device stents and the improvement of perioperative management concept, TIPS has been increasingly and widely accepted worldwide, which is a traditional and constantly innovative interventional technology.

The biggest challenge in the implementation of TIPS is the puncture of portal vein. Traditionally, blind puncture or semi-blind puncture is primarily employed. For patients with portal vein thrombosis or cavernous transformation of portal vein, indirect/direct portography or balloon-assisted puncture are constantly adopted to improve the success rate of puncture, but it is difficult to achieve three-dimensional real-time guidance. Electromagnetic navigation technology can guide and monitor portal vein puncture in a real-time manner, effectively elevate the success rate of puncture and properly explain the significance of precision medicine, which is also an exploration on the road of engineering medicine.