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Patient-specific, touch-based registration during robotic, image-guided partial nephrectomy

AUTHORS

Nimmagadda Naren , Ferguson James M. , Kavoussi Nicholas L. , Pitt Bryn , Barth Eric J. , Granna Josephine , Webster Robert J. , Herrell S. Duke . World Journal of Urology. 2022 ; 40(3). 671-677

ABSTRACT

Image-guidance during partial nephrectomy enables navigation within the operative field alongside a 3-dimensional roadmap of renal anatomy generated from patient-specific imaging. Once a process is performed by the human mind, the technology will allow standardization of the task for the benefit of all patients undergoing robot-assisted partial nephrectomy. Any surgeon will be able to visualize the kidney and key subsurface landmarks in real-time within a 3-dimensional simulation, with the goals of improving operative efficiency, decreasing surgical complications, and improving oncologic outcomes. For similar purposes, image-guidance has already been adopted as a standard of care in other surgical fields; we are now at the brink of this in urology. This review summarizes touch-based approaches to image-guidance during partial nephrectomy, as the technology begins to enter in vivo human evaluation. The processes of segmentation, localization, registration, and re-registration are all described with seamless integration into the da Vinci surgical system; this will facilitate clinical adoption sooner.

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