Application of holographic image and navigation in robotic assisted laparoscopic radical prostatectomy
10.3760/cma.j.cn112330-20210108-00011
- VernacularTitle:基于磁共振图像的全息影像及术中导航技术在机器人根治性前列腺切除术中的应用
- Author:
Gang ZHU
;
Kai ZHANG
;
Lei WANG
;
Jingjing LU
;
Hongbo LI
;
Zichen ZHAO
;
Yanqun NA
- From:
Chinese Journal of Urology
2021;42(4):278-282
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical value of the holographic image and navigation in robotic assisted laparoscopic radical prostatectomy (RARP) .Methods:From Sept. 2020 to Dec. 2020, 5 patients diagnosed with prostate cancer in Beijing United Family Hospital were included in this study. The mean age was 57 years(38-69 years). Before the operation, the engineers established the holographic image based on the enhanced MRI images. The holographic images were used in pre-surgery planning. During the operation, the navigation was achieved by real time fusing holographic images with the robotic surgery endoscopic views. Some important structure such as prostate, bladder neck and the tumor could be observed and monitored in real time. The No.1 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection; The No.2 patient had low-risk prostate cancer, underwent RARP, and the right side neurovascular bundle (NVB) was preserved; The No.3 patient had low-risk prostate cancer, underwent RARP, and the bilateral side NVB was preserved; The No.4 patient had low-risk prostate cancer, underwent RARP, and the right side NVB was preserved; The No.5 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection, and the bilateral side NVB was preserved.Results:All the 5 cases surgeries were successful, no conversion to open surgery, the mean operation time was 161.7min (160-250min), the mean blood loss was 426.7 ml(60-1000 ml). The pathological results were pT 3bN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0 and pT 3aN 1 cM 0, respectively. There was no over Clavien Dindo Ⅱ perioperative complications. 4 patient achieved continence when catheter removal. The PSA level and erectile function were monitored in the follow up. Conclusions:Holographic image navigation might have clinical value in RARP.
