Imaging-assisted endoscopic surgery: Cleveland Clinic experience

Area of Science:

• Urology
• Medical Imaging
• Surgical Technology

Background:

• Minimally invasive urology presents challenges in visualizing complex 3D anatomy.
• Computer-aided image assistance offers potential solutions to enhance surgical precision.

Purpose of the Study:

• To report initial clinical experiences with computer-aided image assistance in minimally invasive urology.
• To evaluate the utility of augmented reality (AR) visualization in laparoscopic procedures.

Main Methods:

• Development of a system integrating real-time ultrasound (US) with preoperative computed tomography (CT) or magnetic resonance imaging (MRI).
• Implementation of an AR visualization system for laparoscopic partial nephrectomy and radical prostatectomy.
• Utilized magnetic and optical sensors for spatial localization of surgical instruments.

Main Results:

• Successful clinical application of image fusion for percutaneous radiofrequency/cryoablation of renal tumors.
• AR visualization demonstrated feasibility and utility in enhancing surgeons' interpretation of 3D anatomy.
• AR facilitated understanding of cancer and vital structures during laparoscopic partial nephrectomy and radical prostatectomy.

Conclusions:

• Computer-aided imaging and AR visualization can increase surgeon precision and confidence.
• These technologies provide crucial preoperative oncological data and insight into surrounding vital anatomies.
• Emerging 3D imaging techniques can guide dissection for improved oncological outcomes and functional preservation.