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

Osamu Ukimura, Monish Aron, Masahiko Nakamoto, Sunao Shoji, Andre Luis De Castro Abreu, Toru Matsugasumi, Andre Berger, Mihir Desai, Inderbir S. Gill

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)625-630
Number of pages6
JournalJournal of endourology
Volume28
Issue number6
DOIs
StatePublished - Jun 1 2014

ASJC Scopus subject areas

  • Urology

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