Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation

Area of Science:

• Minimally Invasive Surgery
• Nuclear Medicine
• Surgical Oncology

Background:

• Radioguided surgery, including sentinel node biopsy, is established in clinical practice.
• Laparoscopic gamma probes offer limited maneuverability in robot-assisted procedures.
• Enhanced probe dexterity is needed to improve surgical precision.

Purpose of the Study:

• To evaluate the in vivo feasibility of a novel tethered DROP-IN gamma probe.
• To assess the probe's utility in robot-assisted laparoscopic surgery for prostate cancer.
• To improve rotational freedom and maneuverability of gamma probes during surgery.

Main Methods:

• Ten prostate cancer patients underwent sentinel node procedures.
• Injecting (indocyanine green-)^99mTechnetium-nanocolloid into the prostate.
• Utilizing the DROP-IN gamma probe inserted via the assistant port during robot-assisted surgery.

Main Results:

• The DROP-IN probe was successfully used with the da Vinci® Si robot.
• Surgeons independently maneuvered the probe using robotic forceps.
• Sentinel nodes were accurately identified and resected using combined radioguided and fluorescence imaging.

Conclusions:

• The DROP-IN gamma probe design is a valuable addition to robot-assisted radioguided surgery.
• This technology enhances maneuverability and precision in minimally invasive procedures.
• Feasibility demonstrated in prostate cancer patients suggests broader applicability.