V6-10 NOVEL PERCUTANEOUS NAVIGATION SYSTEM INTEGRATING GPS TECHNOLOGY WITH MOVABLE TABLET DISPLAY OF SURGICAL 3D MODEL FOR TARGETED FOCAL THERAPY: INITIAL EXPERIENCES IN HUMAN BODY.
Arnaud Marien, Andre Luis Abreu, Sunao Sohji, Toru Matsugasumi, Sameer S Chopra, Raed A. Azhar, Yi Sun, Mihir M. Desai, Inderbir Singh Gill, Osamu Ukimura · The Journal of Urology · 2014
You have accessJournal of UrologyNovel Imaging/Prostate Oncology/Robotics1 Apr 2014V6-10 NOVEL PERCUTANEOUS NAVIGATION SYSTEM INTEGRATING GPS TECHNOLOGY WITH MOVABLE TABLET DISPLAY OF SURGICAL 3D MODEL FOR TARGETED FOCAL THERAPY: INITIAL EXPERIENCES IN HUMAN BODY. Arnaud Marien, Andre Luis Abreu, Sunao Sohji, Toru Matsugasumi, Sameer Chopra, Raed Azhar, Yi Sun, Mihir Desai, Inderbir Gill, and Osamu Ukimura Arnaud MarienArnaud Marien More articles by this author , Andre Luis AbreuAndre Luis Abreu More articles by this author , Sunao SohjiSunao Sohji More articles by this author , Toru MatsugasumiToru Matsugasumi More articles by this author , Sameer ChopraSameer Chopra More articles by this author , Raed AzharRaed Azhar More articles by this author , Yi SunYi Sun More articles by this author , Mihir DesaiMihir Desai More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Osamu UkimuraOsamu Ukimura More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1873AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present the first application of a percutaneous navigation system (Translucent™ Medical, Inc.) integrating GPS technology with a movable tablet display of virtual three dimensional (3D) models. The surgical tools and movable tablet display are tracked by GPS technology and digitally aligned with each other. The system displays real-time internal anatomy, superimposed surgical tools, and navigation aids (i.e. predictive puncture line). The objectives of this study were to assess the feasibility and accuracy of the system in targeted therapy for the prostate and kidney in cadaver. METHODS Gold fiducial-markers (CIVCO Medical), which served as target centers of the virtual tumors (target-fiducial), were implanted in parenchyma of the kidney and prostate. A pre-op CT scan was obtained. The CT-DICOM data were transferred to the system to reconstruct into 3D surgical models. A needle with built-in GPS sensors was used as a therapeutic puncture needle. When the system indicated coincidence of the needle-tip and target-fiducial, another fiducial (treatment-fiducial) was placed through the outer-sheath of the therapeutic needle. A post-op CT was acquired to assess digitized distance between the 2 fiducials. For each target-fiducial, two placements of a treatment-fiducial were attempted (from two different skin incisions >20mm distant). RESULTS Real-time display of the puncturing trajectory superimposed within the 3D model was used to successfully navigate the targeting in all procedures. Navigation was enhanced by color-coded changes to the needle-icon, indicating whether or not the current trajectory was on line to intersect the surgical target. Median time to target was 43 sec. Mean distance from needle-tip to target was 2.5mm (as calculated by the tracking system). Distance between the paired treatment-fiducials was 7.7mm. Distance between target-fiducial and treatment-fiducial was 16.6mm in the prostate and 12.0mm in the kidney. In an analysis of each axial component, errors were significantly greater along z-axis (p<0.01), likely due to the intra-operative pushing down the organ during the puncture, resulting in possible rotation, shift, or deformation of the soft-tissue organ. CONCLUSIONS This virtual navigation system, integration of GPS-technology with movable tablet display, is promising for percutaneous interventions. In order to minimize possible errors, further work is needed to augment the tracking system of intra-corporeal motions or deformations of the organs. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e681 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Arnaud Marien More articles by this author Andre Luis Abreu More articles by this author Sunao Sohji More articles by this author Toru Matsugasumi More articles by this author Sameer Chopra More articles by this author Raed Azhar More articles by this author Yi Sun More articles by this author Mihir Desai More articles by this author Inderbir Gill More articles by this author Osamu Ukimura More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...