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Image guidance for all--TilePro display of 3-dimensionally reconstructed images in robotic partial nephrectomy
Archie Hughes-Hallett1, Philip Pratt2, Erik Mayer1
1Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Objective:
To determine the feasibility of a novel low-barrier-to-entry image guidance system.
Methods:
Initially a randomized crossover study was performed to establish the interface (iPad or 3-dimensional mouse) that minimized both the amount of time required to perform a manual image registration and the error of that registration. A subsequent clinical feasibility study was undertaken on 5 patients undergoing robot-assisted partial nephrectomy. Randomized crossover study primary outcomes were time to task completion, NASA-Task Load Index score, and alignment error (translational and rotational). The Mann-Whitney U test was used to compare groups. Surgeon feedback was sought when assessing the system in a clinical setting.
Results:
In the initial randomized crossover study, the iPad-based system was able to achieve adequate alignment accuracy (Frobenius norm of 0.3; total error of 20.8 mm) in significantly less time (33 seconds; P<.01) than the 3-dimensional mouse interface. The platform received good feedback from the operating surgeon in all instances with the surgeon commenting particularly on the improved appreciation of hilar vascular anatomy.
Conclusion:
In this study, we have demonstrated the feasibility of a "low-barrier-to-entry" image guidance system in a clinical setting. The system was able to achieve swift and sufficiently accurate alignment, with little impact on the surgical workflow.
