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Revolutionizing (robot-assisted) laparoscopic gamma tracing using a drop-in gamma probe technology.
Matthias N van Oosterom1, Hervé Simon2, Laurent Mengus2
1Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center (LUMC) Leiden, The Netherlands.
American Journal of Nuclear Medicine and Molecular Imaging
|April 13, 2016
Summary
A new drop-in gamma probe (DIGP) offers improved maneuverability in laparoscopic surgery. This technology enhances lesion identification by allowing better positioning, especially in complex cases with low-activity targets near high background radiation.
Area of Science:
- Minimally Invasive Surgery
- Nuclear Medicine
- Surgical Instrumentation
Background:
- Laparoscopic gamma probes (LGPs) have limited maneuverability (4 degrees of freedom), hindering lesion identification in complex surgeries.
- Identifying low-activity lesions near high-activity backgrounds is challenging with conventional LGPs.
Purpose of the Study:
- To investigate a novel drop-in gamma probe (DIGP) technology for enhanced maneuverability in laparoscopic radioguided surgery.
- To evaluate the impact of DIGP grip design and orientation on pick-up, maneuverability, and scanning capabilities with laparoscopic and robotic forceps.
Main Methods:
- Phantom experiments were conducted to assess the DIGP's ability to distinguish low-activity targets from high-activity backgrounds at various detector angles.
- DIGP prototypes with different grip orientations (0°, 45°, 90°, 135°) were engineered and tested for pick-up and maneuverability using conventional laparoscopic (4 DOF) and robotic (6 DOF) forceps.
- Ex vivo clinical setup evaluation by a surgeon assessed the convenience of DIGP pick-up.
Main Results:
- Phantom studies demonstrated that DIGP could distinguish sources only when the detector was positioned >90° from the background, highlighting the importance of probe positioning.
- The DIGP exhibited superior maneuverability and scanning direction range with robotic forceps, particularly the 90° grip design (0-180° range).
- The 45° grip design was rated most convenient for pick-up by the surgeon in the ex vivo setup.
Conclusions:
- The drop-in gamma probe (DIGP) technology offers a viable solution to overcome the maneuverability limitations of conventional laparoscopic gamma probes.
- Optimizing DIGP grip design and grasping angle significantly enhances its utility for both conventional and robot-assisted laparoscopic gamma tracing.
- DIGP technology improves lesion detection accuracy in challenging surgical scenarios.
Keywords:
Radioguided surgerygamma probeinterventional molecular imaginglaparoscopic surgeryrobot-assisted surgerysentinel lymph node biopsyurology
