当前位置： SCI文献检索 > EUROPEAN UROLOGY期刊下所有文献 > Augmented reality: a new tool to improve surgical accuracy during laparoscopic partial nephrectomy? Preliminary in vitro and in vivo results.

Augmented reality: a new tool to improve surgical accuracy during laparoscopic partial nephrectomy? Preliminary in vitro and in vivo results.

Abstract：

BACKGROUND:Use of an augmented reality (AR)-based soft tissue navigation system in urologic laparoscopic surgery is an evolving technique. OBJECTIVE:To evaluate a novel soft tissue navigation system developed to enhance the surgeon's perception and to provide decision-making guidance directly before initiation of kidney resection for laparoscopic partial nephrectomy (LPN). DESIGN, SETTING, AND PARTICIPANTS:Custom-designed navigation aids, a mobile C-arm capable of cone-beam imaging, and a standard personal computer were used. The feasibility and reproducibility of inside-out tracking principles were evaluated in a porcine model with an artificially created intraparenchymal tumor in vitro. The same algorithm was then incorporated into clinical practice during LPN. INTERVENTIONS:Evaluation of a fully automated inside-out tracking system was repeated in exactly the same way for 10 different porcine renal units. Additionally, 10 patients underwent retroperitoneal LPNs under manual AR guidance by one surgeon. MEASUREMENTS:The navigation errors and image-acquisition times were determined in vitro. The mean operative time, time to locate the tumor, and positive surgical margin were assessed in vivo. RESULTS AND LIMITATIONS:The system was able to navigate and superpose the virtually created images and real-time images with an error margin of only 0.5 mm, and fully automated initial image acquisition took 40 ms. The mean operative time was 165 min (range: 135-195 min), and mean time to locate the tumor was 20 min (range: 13-27 min). None of the cases required conversion to open surgery. Definitive histology revealed tumor-free margins in all 10 cases. CONCLUSIONS:This novel AR tracking system proved to be functional with a reasonable margin of error and image-to-image registration time. Mounting the pre- or intraoperative imaging properties on real-time videoendoscopic images in a real-time manner will simplify and increase the precision of laparoscopic procedures.

journal_name

Eur Urol

journal_title

European urology

authors

Teber D,Guven S,Simpfendörfer T,Baumhauer M,Güven EO,Yencilek F,Gözen AS,Rassweiler J

doi

10.1016/j.eururo.2009.05.017

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

332-8

issue

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(09)00521-1

journal_volume

pub_type

杂志文章

在线工具

Augmented reality: a new tool to improve surgical accuracy during laparoscopic partial nephrectomy? Preliminary in vitro and in vivo results.