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Hyperaccuracy Three-Dimensional Model and Augmented Reality/Mixed Reality for Robot-Assisted Retroperitoneal Lymph
Markus Angerer1, Mattis Franke1, Klaus-Peter Dieckmann1
1Department of Urology, Asklepios Klinik Altona, Hamburg, Germany.
Objective:
To evaluate the feasibility of hyperaccuracy three-dimensional (HA3D) virtual models with augmented reality (AR) in robot-assisted retroperitoneal lymph node dissection (R-RPLND) for testicular cancer.
Methods:
A 35-year-old male with 4 cm interaortocaval seminoma recurrence underwent unilateral template R-RPLND. A patient-specific HA3D model was generated from contrast-enhanced CT using Avatar Medical software and integrated into preoperative planning and intraoperative AR navigation.
Results:
HA3D modeling enabled precise preoperative identification of a critical renal arterial branch adjacent to the tumor, facilitating safe dissection. R-RPLND was completed in 76 min with minimal blood loss (30 mL) and no complications. Pathology confirmed 4.5 cm viable seminoma metastasis. Nine-month follow-up showed no recurrence.
Conclusion:
This proof-of-concept case demonstrates successful integration of HA3D virtual models and AR into R-RPLND workflow, potentially enhancing anatomical visualization, surgical planning, and procedural safety. Multicenter prospective studies are needed to validate reproducibility and clinical benefit.
