Three-dimensional surgical navigation model with TilePro display during robot-assisted radical prostatectomy.

Autor: Ukimura O; Center of Image-Guided Surgery and Robotic Surgery, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California., Aron M, Nakamoto M, Shoji S, Abreu AL, Matsugasumi T, Berger A, Desai M, Gill IS
Jazyk: angličtina
Zdroj: Journal of endourology [J Endourol] 2014 Jun; Vol. 28 (6), pp. 625-30. Date of Electronic Publication: 2014 May 08.
DOI: 10.1089/end.2013.0749
Abstrakt: Abstract To facilitate robotic nerve-sparing radical prostatectomy, we developed a novel three-dimensional (3D) surgical navigation model that is displayed on the TilePro function of the da Vinci® surgeon console. Based on 3D transrectal ultrasonography (TRUS)-guided prostate biopsies, we reconstructed a 3D model of the TRUS-visible, histologically confirmed "index" cancer lesion in 10 consecutive patients. Five key anatomic structures (prostate, image-visible biopsy-proven "index" cancer lesion, neurovascular bundles, urethra, and recorded biopsy trajectories) were image-fused and displayed onto the TilePro function of the robotic console. The 3D model facilitated careful surgical dissection in the vicinity of the biopsy-proven index lesion. Geographic location of the index lesion on the final histology report correlated with the software-created 3D model. Negative surgical margins were achieved in 90%, except for one case with extensive extra-prostate extension. At postoperative 3 months, prostate-specific antigen levels were undetectable (<0.03 ng/mL) in all cases. The initial experience of the navigation model is presented.
Databáze: MEDLINE