Console-integrated real-time three-dimensional image overlay navigation for robot-assisted partial nephrectomy with selective arterial clamping: early single-centre experience with 17 cases.

Junya Furukawa, Hideaki Miyake, Kazushi Tanaka, Maki Sugimoto, Masato Fujisawa
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引用次数: 39

Abstract

Background: The objective of this study was to describe our early experience with robot-assisted partial nephrectomy (RAPN) incorporating selective arterial clamping, using an image overlay navigation system.

Methods: Three-dimensional images were reconstructed from computed tomography using open source processing software, OsiriX, and were directly visualized on the screen of a da Vinci surgeon's console with TilePro multi-input display functions. Using this imaging system, RAPN with selective arterial clamping was performed in 17 patients with renal tumours.

Results: The intraoperative image overlay navigation system made it possible to clearly show the tumour position and vascular supply within the console's field of view, and facilitate selective arterial clamping during RAPN, resulting in a mean decrease in estimated glomerular filtration rates at both 1 and 4 weeks after RAPN < 10 ml/min/1.73 m(2) .

Conclusions: RAPN with selective arterial clamping using this innovative imaging system could be a useful alternative to conventional RAPN.

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机器人辅助肾部分切除术选择性动脉夹闭的控制台集成实时三维图像叠加导航:早期单中心17例经验
背景:本研究的目的是描述我们的早期经验,机器人辅助部分肾切除术(RAPN)结合选择性动脉夹紧,使用图像覆盖导航系统。方法:利用开源处理软件OsiriX重建计算机断层扫描的三维图像,并在具有TilePro多输入显示功能的达芬奇外科控制台屏幕上直接显示。应用该成像系统对17例肾肿瘤患者行选择性动脉夹持RAPN。结果:术中图像覆盖导航系统可以清楚地显示肿瘤位置和控制台视野内的血管供应,并促进RAPN期间的选择性动脉夹紧,导致RAPN后1周和4周肾小球滤过率的平均下降。结论:使用这种创新的成像系统进行选择性动脉夹紧的RAPN可能是传统RAPN的有用替代方案。
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