Image-Guided Robotic Surgery for Sentinel Lymph Node Status Assessment in Uterine Cancers Using Ultrasound Drop-in...

Area of Science:

• Gynecologic Oncology
• Surgical Technology
• Medical Imaging

Background:

• Sentinel lymph node (SLN) biopsy is recommended for uterine cancers to minimize complications.
• Limitations of current SLN techniques include low frozen-section accuracy and risk of specimen loss.
• Image-guided surgery offers real-time assessment to overcome these limitations.

Purpose of the Study:

• To describe the surgical procedure of intraoperative robotic ultrasound for sentinel lymph node assessment in uterine cancers.
• To introduce a novel image-guided approach for enhancing SLN dissection accuracy.

Main Methods:

• Utilized a robotic ultrasound probe (Arietta L43K) on the da Vinci Xi platform.
• Integrated near-infrared imaging and robotic ultrasound for real-time SLN identification and assessment.
• Performed in vivo and ex vivo ultrasound analysis of SLNs following cervical indocyanine green injection.

Main Results:

• Detailed a ten-step procedure for robotic ultrasound-guided SLN assessment.
• Demonstrated the feasibility of integrating robotic ultrasound with near-infrared imaging for SLN visualization.
• Captured in vivo and ex vivo ultrasound images and videos for comprehensive analysis.

Conclusions:

• Image-guided robotic lymph node ultrasound is a feasible and promising technique for real-time SLN assessment.
• Clinical validation is pending, with a prospective study (R-LYNUS) currently in progress.
• The technique aims to improve the accuracy and reliability of SLN procedures in gynecologic oncology.