Patient-specific, touch-based registration during robotic, image-guided partial nephrectomy.

Journal: World journal of urology
Published Date:

Abstract

Image-guidance during partial nephrectomy enables navigation within the operative field alongside a 3-dimensional roadmap of renal anatomy generated from patient-specific imaging. Once a process is performed by the human mind, the technology will allow standardization of the task for the benefit of all patients undergoing robot-assisted partial nephrectomy. Any surgeon will be able to visualize the kidney and key subsurface landmarks in real-time within a 3-dimensional simulation, with the goals of improving operative efficiency, decreasing surgical complications, and improving oncologic outcomes. For similar purposes, image-guidance has already been adopted as a standard of care in other surgical fields; we are now at the brink of this in urology. This review summarizes touch-based approaches to image-guidance during partial nephrectomy, as the technology begins to enter in vivo human evaluation. The processes of segmentation, localization, registration, and re-registration are all described with seamless integration into the da Vinci surgical system; this will facilitate clinical adoption sooner.

Authors

  • Naren Nimmagadda
    Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • James M Ferguson
    Garvan Institute of Medical Research, Darlinghurst 2010, NSW, Australia.
  • Nicholas L Kavoussi
    Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Bryn Pitt
    Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee, USA.
  • Eric J Barth
    Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee, USA.
  • Josephine Granna
    Department of Mechanical Engineering, School of Engineering, Vanderbilt University, Nashville, Tennessee, USA.
  • Robert J Webster
  • S Duke Herrell
    Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA.