Intraoperative Registered Transrectal Ultrasound Guidance for Robot-Assisted Laparoscopic Radical Prostatectomy

Mohareri, Omid; Ischia, Joseph; Black, Peter C.; Schneider, Charles L.; Lobo, Julio; Goldenberg, Larry; Salcudean, Septimiu E.

doi:10.1016/j.juro.2014.05.124

Cited by 35 publications

(15 citation statements)

References 15 publications

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“…To identify the anatomical structures such as vessels and tumours, intraoperative ultrasound has been used [2]. However, a well-known drawback of using intraoperative ultrasound is that surgeons need to interpret the ultrasound images and perceptually relate these images to the operative scene captured by a laparoscope [3]. This is particularly challenging, as the ultrasound images and laparoscopic videos are displayed separately on different screens.…”

Section: Introductionmentioning

confidence: 99%

Real-time surgical tool tracking and pose estimation using a hybrid cylindrical marker

Zhang

Chan

et al. 2017

Int J CARS

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PurposeTo provide an integrated visualisation of intraoperative ultrasound and endoscopic images to facilitate intraoperative guidance, real-time tracking of the ultrasound probe is required. State-of-the-art methods are suitable for planar targets while most of the laparoscopic ultrasound probes are cylindrical objects. A tracking framework for cylindrical objects with a large work space will improve the usability of the intraoperative ultrasound guidance.MethodsA hybrid marker design that combines circular dots and chessboard vertices is proposed for facilitating tracking cylindrical tools. The circular dots placed over the curved surface are used for pose estimation. The chessboard vertices are employed to provide additional information for resolving the ambiguous pose problem due to the use of planar model points under a monocular camera. Furthermore, temporal information between consecutive images is considered to minimise tracking failures with real-time computational performance.ResultsDetailed validation confirms that our hybrid marker provides a large working space for different tool sizes (6–14 mm in diameter). The tracking framework allows translational movements between 40 and 185 mm along the depth direction and rotational motion around three local orthogonal axes up to . Comparative studies with the current state of the art confirm that our approach outperforms existing methods by providing nearly 100% detection rates and accurate pose estimation with mean errors of 2.8 mm and 0.72. The tracking algorithm runs at 20 frames per second for image resolution videos.ConclusionExperiments show that the proposed hybrid marker can be applied to a wide range of surgical tools with superior detection rates and pose estimation accuracies. Both the qualitative and quantitative results demonstrate that our framework can be used not only for assisting intraoperative ultrasound guidance but also for tracking general surgical tools in MIS.

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Section: Introductionmentioning

confidence: 99%

Real-time surgical tool tracking and pose estimation using a hybrid cylindrical marker

Zhang

Chan

et al. 2017

Int J CARS

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“…This review focused on the clinical applicability of intraoperative margin assessment, and several innovative technologies are developed for optical guidance during PCa surgery. Another strategy to decrease positive margins includes surgical experience, preoperative selection, preoperative models, and radioguided surgery [34][35][36]. Investigations in the latter area are already on-going, as well as in combination with augmented and virtual reality [37,38].…”

Section: Alternative and Future Technologiesmentioning

confidence: 99%

State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

Heuvel

Veen

Huizing

et al. 2021

European Urology Focus

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Context: The main challenge in radical prostatectomy is complete excision of malignant tissue, while preserving continence and erectile function. Positive surgical margins (PSMs) occur in up to 38% of cases, are associated with tumour recurrences, and may result in debilitating additional therapies. Despite surgical developments for prostate cancer (PCa), no technology is yet implemented to assess surgical margins of the entire prostatic surface intraoperatively. Objective: The aim of this systematic review is to provide an overview of novel imaging methods developed for intraoperative margin assessment in PCa surgery, which are compared with standard postoperative histopathology. Evidence acquisition: A literature search of the last 10 yr was conducted in the Scopus, PubMed, and Embase (Ovid) databases. Eligible articles had to report the PSM rate according to their intraoperative margin assessment technology in comparison with standard histopathology. Evidence synthesis: The search resulted in 616 original articles, of which 11 were included for full-text review. The main technical developments in PCa margin assessment included optical coherence tomography, photodynamic diagnosis with 5-aminolevulinic acid, spectroscopy, and enhanced microscopy. These techniques are described and their main advantages, limitations, and applications in the clinical setting are discussed. Conclusions: Several imaging methods are suggested in literature for the detection of positive margins during PCa surgery. Despite promising qualifications of the mentioned technologies, many struggle to find implementation in the clinic. Surgical conditions hampering the signal, long imaging times, and comparison with histopathology are mutual challenges. The next step towards reduction of PSMs in PCa surgery includes evaluation of these technologies in large clinical trials. Patient summary: In this review, new technologies are reported that can assist the surgeon by detecting insufficient removal of all tumorous tissue during surgery, instead of the standard postoperative histopathological assessment. Currently, it is not clear whether these technologies improve the patient outcome directly; however, the review shows potential future implementations.

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“…It has potential in prostatectomy and other procedures where it can help differentiate tissues based on their echogenicity. 92 93 A predominance of 3-D systems with smaller sized cameras at 4 mm (such as the Visionsense VSiii) and smaller will offer stereoscopy with increased use of other ports for surgery. Tissue imaging with photodynamic capture and enhanced microscopy ranging from Narrow Band Imaging (NBI), Fluorescence Lifetime Imaging (FLIM), Optical coherence tomography and Flexible Confocal Microscopy (FCM) [94][95][96] will offer increased real-time visual histological data that can identify tumour cells and margins.…”

Section: Visualizationmentioning

confidence: 99%

The evolution of robotic surgery: surgical and anaesthetic aspects

Ashrafian

Clancy

Grover

et al. 2017

British Journal of Anaesthesia

131

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Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, obstacles and limitations of robotic surgery and its future potential including integrated real-time anatomical and immune-histological imaging and data assimilation with improved visualisation, haptic feedback and robot-surgeon interactivity. We consider current evidence, cost-effectiveness and the learning curve in relation to the surgical and anaesthetic journey, and what is required to continue to realise improvements in surgical operative care. The innovative impact of this technology holds the potential to achieve transformative clinical improvements. However, despite over 30 yr of incremental advances it remains formative in its innovative disruption.

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Intraoperative Registered Transrectal Ultrasound Guidance for Robot-Assisted Laparoscopic Radical Prostatectomy

Cited by 35 publications

References 15 publications

Real-time surgical tool tracking and pose estimation using a hybrid cylindrical marker

Real-time surgical tool tracking and pose estimation using a hybrid cylindrical marker

State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

The evolution of robotic surgery: surgical and anaesthetic aspects

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