Application of holographic image navigation in urological laparoscopic and robotic surgery
Gang Zhu, Jinchun Xing, Guobin Weng, Zhiquan Hu, Ningchen Li, He Zhu, Pingsheng Gao, Zhihua Wang, Weizhi Zhu, Kai Zhang, Hongbo Li, Zhun Wu, Rui Zhu, Xifeng Wei, Yanan Wang, Qun Xie, Bing Fu, Xinghuan Wang, Lin Qi, Xin Yao, Tiejun Pan, Delin Wang, Nan Liu, Jianguang Qiu, Jianggen Yang, Bao Zhang, Zhuowei Liu, Hui Han, Gang Li, Bin Zhang, Manli Na, Jingjing Lu, Lei Wang, Zichen Zhao, Yanqun Na
Abstract
ObjectiveTo evaluate the clinical value of holographic image navigation in urological laparoscopic and robotic surgery.
MethodsThe data of patients were reviewed retrospectively for whom accepted holographic image navigation laparoscopic and robotic surgery from Jan. 2019 to Dec. 2019 in Beijing United Family Hospital and other 18 medical centers, including 78 cases of renal tumor, 2 cases of bladder cancer, 2 cases of adrenal gland tumor, 1 cases of renal cyst, 1 case of prostate cancer, 1 case of sweat gland carcinoma with lymph node metastasis, 1 case of pelvic metastasis after radical cystectomy. All the patients underwent operations. In the laparoscopic surgery group, there were 27 cases of partial nephrectomy, 1 case of radical prostatectomy, 2 cases of radical cystectomy and 2 cases of adrenalectomy. In the da Vinci robotic surgery group of 54 cases, there were 51 cases of partial nephrectomy, 1 case of retroperitoneal lymph node dissection, 1 case of retroperitoneal bilateral renal cyst deroofing and 1 case of resection of pelvic metastasis. There were 41 partial nephrectomy patients with available clinical data for statistic, with a median age of 53.5 years (range 24-76), including 26 males and 15 females. The median R. E.N.A.L score was 7.8 (range 4-11). Before the operation, the engineers established the holographic image based on the contrast CT images and reports. The surgeon applied the holographic image for preoperative planning. During the operation, the navigation was achieved by real time fusing holographic images with the laparoscopic surgery images in the screen.
ResultsAll the procedures had been complete uneventfully. The holographic images helped surgeon in understanding the visual three- dimension structure and relation of vessels supplying tumor or resection tissue, lymph nodes and nerves. By manipulating the holographic images extracorporeally, the fused image guide surgeons about location vessel, lymph node and other important structure and then facilitate the delicate dissection. For the 41 cases with available clinical data including 23 cases of robotic-assisted partial nephrectomy and 18 cases of laparoscopic nephrectomy, the median operation time was 140(range 50-225)min, the median warm ischemia time was 23(range 14-60)min, the median blood loss was 80(range 5-1 200)ml. In the robotic surgery group, the median operation time was 140(range 50-215)min, the median warm ischemia time was 21(range 17-40)min, the median blood loss was 150(range 30-1 200)ml. In the laparoscopic surgery group, the median operation time was 160(range 80-225)min, the median warm ischemia time was 25(range 14-60)min, the median blood loss was 50(range 5-1 200)ml. All the patients had no adjacent organ injury during operation. There were 2 cases with Clavien Ⅱcomplications. One required transfusion and the other one suffered hematoma post-operation. However, the tumors were located in the renal hilus for these 2 cases and the R. E.N.A.L scores were both 11.
ConclusionsHolographic image navigation can help location and recognize important anatomic structures during the surgical procedures.. This technique will reduce the tissue injury, decrease the complications and improve the success rate of surgery.
Key words:
Laparoscopic; 3 dimension image reconstruction; Holographic Imaging; Laparoscopic surgery; Robotic surgery
Contributor Information
Gang Zhu
Department of Urology, Beijing United Family Hospital, Beijing 100015, China
Jinchun Xing
Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
Guobin Weng
Department of Urology, Ningbo Yinzhou No.2 Hospital, Ningbo 315192, China
Zhiquan Hu
Department of Urology, Tongji Medical College Huazhong University of Science &
Technology, Wuhan 430030, China
Ningchen Li
Department of Urology, Peking University Shougang Hospital, Peking University Wu Jieping Urology Center, Beijing 100144, China
He Zhu
Department of Urology, Peking University Shougang Hospital, Peking University Wu Jieping Urology Center, Beijing 100144, China
Pingsheng Gao
Department of Urology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
Zhihua Wang
Department of Urology, Tongji Medical College Huazhong University of Science &
Technology, Wuhan 430030, China
Weizhi Zhu
Department of Urology, Ningbo Yinzhou No.2 Hospital, Ningbo 315192, China
Kai Zhang
Department of Urology, Beijing United Family Hospital, Beijing 100015, China
Hongbo Li
Department of Urology, Beijing United Family Hospital, Beijing 100015, China
Zhun Wu
Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
Rui Zhu
Department of Urology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
Xifeng Wei
Department of Urology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China
Yanan Wang
Department of Urology, Tongji Medical College Huazhong University of Science &
Technology, Wuhan 430030, China
Qun Xie
Department of Urology, Zhuhai People's Hospital, Zhuhai 519000, China
Bing Fu
Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
Xinghuan Wang
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
Lin Qi
Department of Urology, XiangYa Hospital Central South University, Changsha 410008, China
Xin Yao
Department of Urology, Tianjin Medical University Cancer Institute &
Hospital, Tianjin 300060, China
Tiejun Pan
Department of Urology, General Hospital of the Central Theater Command of the Chinese PLA, Wuhan 430070, China
Delin Wang
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 430016, China
Nan Liu
Department of Urology, Chongqing University Cancer Hospital, Chongqing 400030, China
Jianguang Qiu
Department of Urology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510655, China
Jianggen Yang
Department of Urology, Shenzhen Luohu People's Hospital, Shenzhen 518000, China
Bao Zhang
Department of Urology, Aerospace Central Hospital, Beijing 100049, China
Zhuowei Liu
Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
Hui Han
Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
Gang Li
Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
Bin Zhang
Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
Manli Na
Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
Jingjing Lu
Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
Lei Wang
Department of Urology, Peking University Shougang Hospital, Peking University Wu Jieping Urology Center, Beijing 100144, China
Zichen Zhao
Department of Urology, Peking University Shougang Hospital, Peking University Wu Jieping Urology Center, Beijing 100144, China
Yanqun Na
Department of Urology, Peking University Shougang Hospital, Peking University Wu Jieping Urology Center, Beijing 100144, China
