Integrated image navigation system using head-mounted display in "RoboSurgeon" endoscopic radical prostatectomy.

Area of Science:

• Surgical Navigation
• Medical Imaging
• Robotics in Surgery

Background:

• Minimally invasive surgery (MIS) relies heavily on accurate visual information for safety and efficacy.
• Current navigation systems may not always provide an optimal ergonomic or integrated visual experience for surgeons.

Purpose of the Study:

• To develop and assess the feasibility of the RoboSurgeon System, an integrated image navigation system.
• The system combines head-mounted displays (HMDs) with multiple image modalities for enhanced surgical visualization.

Main Methods:

• The RoboSurgeon System was developed, integrating preoperative magnetic resonance (MR) images and intraoperative real-time endoscopic, transrectal ultrasound (TRUS), and HMD-mounted camera views.
• These integrated images were displayed synchronously on HMDs in a four-split screen mode during gasless single-port endoscopic radical prostatectomy in 5 prostate cancer patients.
• A robotically manipulated TRUS system was utilized to aid in identifying boundaries with adjacent structures, referencing MR images.

Main Results:

• The integrated image navigation system was successfully implemented in 5 patients undergoing radical prostatectomy.
• The system facilitated endoscopic identification of boundaries with adjacent structures by referencing MR images via TRUS.
• No intraoperative or postoperative adverse events were recorded during the study.

Conclusions:

• Integrated image navigation using HMDs as individualized monitors is feasible for minimally invasive surgery.
• The RoboSurgeon System offers a natural ergonomic position for surgeons and may improve the identification of correct dissection planes.
• Further evaluation is warranted to determine the full efficacy of the RoboSurgeon System in surgical procedures.