Tandem-robot assisted laparoscopic radical prostatectomy to improve the neurovascular bundle visualization: a feasibility study

Autor: Bruce J. Trock, Doru Petrisor, Dan Stoianovici, Chunwoo Kim, Bogdan Vigaru, Shadie Badaan, Kenneth S. Tseng, Pierre Mozer, Felix Schafer, Misop Han
Přispěvatelé: Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut des Systèmes Intelligents et de Robotique (ISIR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance aux Gestes et Applications THErapeutiques (AGATHE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), LENS, University of Fiorentino, Urology Robotics Lab (URObotics), Johns Hopkins University (JHU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
Laparoscopic radical prostatectomy
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
Urology
medicine.medical_treatment
030232 urology & nephrology
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
urologic and male genital diseases
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
[SPI.AUTO]Engineering Sciences [physics]/Automatic
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Laparoscopy
Ultrasonography
Interventional
ComputingMilieux_MISCELLANEOUS
Aged
Prostatectomy
medicine.diagnostic_test
business.industry
Ultrasound
Prostate
Prostatic Neoplasms
Equipment Design
Robotics
Middle Aged
Neurovascular bundle
3. Good health
Surgery
Visualization
030220 oncology & carcinogenesis
Feasibility Studies
Robot assisted laparoscopic radical prostatectomy
Radiology
business
Surgical robot
Zdroj: Urology
Urology, 2011, 77 (2), pp.502-506
Urology, 2011, 77 (2), pp.502-506. ⟨10.1016/j.urology.2010.06.064⟩
ISSN: 0090-4295
Popis: International audience; OBJECTIVES To examine the feasibility of image-guided navigation using transrectal ultrasound (TRUS) to visualize the neurovascular bundle (NVB) during robot-assisted laparoscopic radical prostatectomy (RALP). The preservation of the NVB during radical prostatectomy improves the postoperative recovery of sexual potency. The accompanying blood vessels in the NVB can serve as a macroscopic landmark to localize the microscopic cavernous nerves in the NVB.METHODS A novel, robotic transrectal ultrasound probe manipulator (TRUS Robot) and three-dimensional (3-D) reconstruction software were developed and used concurrently with the daVinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) in a tandem-robot assisted laparoscopic radical prostatectomy (T-RALP).RESULTS After appropriate approval and informed consent were obtained, 3 subjects underwent T-RALP without associated complications. The TRUS Robot allowed a steady handling and remote manipulation of the TRUS probe during T-RALP. It also tracked the TRUS probe position accurately and allowed 3-D image reconstruction of the prostate and surrounding structures. Image navigation was performed by observing the tips of the daVinci surgical instruments in the live TRUS image. Blood vessels in the NVB were visualized using Doppler ultrasound.CONCLUSIONS Intraoperative 3-D image-guided navigation in T-RALP is feasible. The use of TRUS during radical prostatectomy can potentially improve the visualization and preservation of the NVB. Further studies are needed to assess the clinical benefit of T-RALP.
Databáze: OpenAIRE
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