V1268 Novel Surgical Tile-pro Navigation With 3d Prostate Cancer Model During Robot-assisted Radical Prostatectomy
Year: 2013
Type: conference-abstract
Abstract: You have accessJournal of UrologyProstate Oncology: Novel Imaging and Focal Therapy1 Apr 2013V1268 NOVEL SURGICAL TILE-PRO NAVIGATION WITH 3D PROSTATE CANCER MODEL DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY Andre Luis de Castro Abreu, Masahiko Nakamoto, Sunao Shoji, Scott Leslie, Andre Berger, Alvin Goh, Mihir Desai, Monish Aron, Inderbir Gill, and Osamu Ukimura Andre Luis de Castro AbreuAndre Luis de Castro Abreu Los Angeles, CA More articles by this author , Masahiko NakamotoMasahiko Nakamoto Los Angeles, CA More articles by this author , Sunao ShojiSunao Shoji Los Angeles, CA More articles by this author , Scott LeslieScott Leslie Los Angeles, CA More articles by this author , Andre BergerAndre Berger Los Angeles, CA More articles by this author , Alvin GohAlvin Goh Los Angeles, CA More articles by this author , Mihir DesaiMihir Desai Los Angeles, CA More articles by this author , Monish AronMonish Aron Los Angeles, CA More articles by this author , Inderbir GillInderbir Gill Los Angeles, CA More articles by this author , and Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2622AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To demonstrate a novel surgical navigation system using three-dimensional (3D) prostate cancer (PCa) model, shown in the “Tile-pro display“ of da Vinci® surgical system during robot-assisted radical prostatectomy (RARP), based on use of our cutting-edge technology of the image-based 3D mapping technology. METHODS The biopsy-proven image-visible 3D cancer model was reconstructed from 0.3 mm step sectional transrectal ultrasound (TRUS), which were acquired in our routine outpatient biopsy protocol of “real-time TRUS-MRI fusion-based 3D cancer mapping technique (Urostation®, Koelis)”. Since we have orientation of the biopsy specimens by inking technique of the distal end, the actual cancer location and length on each core were color-coded in red, while benign in green. Based on digitalized 3D data, our software fused surface rendered 3D models in five key anatomic aspects, including the prostate, image-visible biopsy-proven cancer, neurovascular bundles (NVB), urethra, and color-coded biopsy trajectories. The model was then shown in the “Tile-pro display” during RARP. Intra-operatively the 3D model was tracked according to the surgeon's view real-timely. 10 patients with localized PCa, median PSA 6.7 ng/ml and Gleason score 7 (6-8) underwent RARP with the navigation system. RESULTS Navigation: The “tile-pro” 3D navigation provided location and risk of extra-prostatic extension of the biopsy-proven cancer beyond the surgical view (Figure) to achieve negative surgical margin in 90% except one case with extensive pT3a disease. Cancer location on the 3D model of the index lesion matched (100%) with final pathology. It facilitated intra-operative planning and decision making of complete/partial nerve sparing or sacrificing the NVB at specific location. Perioperative: There were no perioperative complications, the median estimated blood loss, operative time and hospital stay were was 100 ml, 180 min and 2 days respectively. CONCLUSIONS 3D surgical navigation in “Tile-pro display” precisely identified the 3D location of biopsy-proven cancer beyond the surgical view, to facilitate careful surgical dissection adjacent to the index cancer to achieve negative surgical margins. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e519-e520 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andre Luis de Castro Abreu Los Angeles, CA More articles by this author Masahiko Nakamoto Los Angeles, CA More articles by this author Sunao Shoji Los Angeles, CA More articles by this author Scott Leslie Los Angeles, CA More articles by this author Andre Berger Los Angeles, CA More articles by this author Alvin Goh Los Angeles, CA More articles by this author Mihir Desai Los Angeles, CA More articles by this author Monish Aron Los Angeles, CA More articles by this author Inderbir Gill Los Angeles, CA More articles by this author Osamu Ukimura Los Angeles, CA More articles by this author Expand All Advertisement Advertisement Loading ...
Source: The Journal of Urology
Authors: Andre Luis de Castro Abreu, Masahiko Nakamoto, Sunao Shoji, Scott Leslie, Andre Berger, Alvin Goh, Mihir Desai, Monish Aron, Inderbir Gill, Osamu Ukimura
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4245622970