To facilitate robotic nerve-sparing radical prostatectomy, we developed a novel three dimensional (3D) surgical navigation model which is displayed on the Tile-Pro function of the da Vinci® surgeon console.
Based on 3-D trans-rectal ultrasound (TRUS)-guided prostate biopsies (Urostation®, Koelis), we reconstructed a 3-D 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 Tile-Pro function of the robotic console. 3D model facilitated careful surgical dissection in the vicinity of the biopsy-proven 'index' lesion. Geographic location of the 'index lesion' on final histology correlated with the software-created 3D model. Negative surgical margins were achieved in 90%, except for one case with extensive extra-prostate extension. At post-operative 3 months, PSA were undetectable (< 0.03 ng/ml) in all cases. The initial experience of the navigation model is presented.
Written by:
Ukimura O, Aron M, Nakamoto M, Shoji S, Abreu AL, Matsugasumi T, Berger A, Desai M, Gill IS. Are you the author?
University of Southern California/Norris Cancer Center, USC Institute of Urology, 1441 Eastlake Ave 7416, USC Norris Cancer center, Los Angeles, California, United States.
Reference: J Endourol. 2014 Jan 22. Epub ahead of print.
doi: 10.1089/end.2013.0749
PubMed Abstract
PMID: 24450285
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