Hyperaccuracy Three-Dimensional Model and Augmented Reality/Mixed Reality for Robot-Assisted Retroperitoneal Lymph...

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Testicular cancer recurrence often requires retroperitoneal lymph node dissection.
• Robot-assisted retroperitoneal lymph node dissection (R-RPLND) offers minimally invasive options.
• Enhanced visualization tools are crucial for complex oncologic surgeries.

Purpose of the Study:

• To assess the feasibility of using hyperaccuracy 3D (HA3D) virtual models with augmented reality (AR) in R-RPLND.
• To evaluate the impact of HA3D-AR integration on surgical planning and execution for testicular cancer.
• To determine the potential benefits for anatomical visualization and procedural safety.

Main Methods:

• A patient-specific HA3D model was created from contrast-enhanced CT scans.
• The HA3D model was integrated into preoperative planning and intraoperative AR navigation.
• Unilateral template R-RPLND was performed on a 35-year-old male with seminoma recurrence.

Main Results:

• HA3D modeling precisely identified a critical renal artery adjacent to the tumor, aiding safe dissection.
• R-RPLND was completed in 76 minutes with minimal blood loss (30 mL) and no complications.
• Pathology confirmed viable seminoma metastasis; 9-month follow-up showed no recurrence.

Conclusions:

• This case demonstrates the successful integration of HA3D virtual models and AR in R-RPLND.
• The technology shows potential for improving anatomical visualization, surgical planning, and safety in oncologic procedures.
• Further multicenter prospective studies are required to confirm reproducibility and clinical benefits.