Electromagnetically tracked partial nephrectomy navigation: demonstration of concept
Hillary Lia, Zachary M. C. Baum, Thomas Vaughan, Tamás Ungi, Thomas Brian McGregor, Gábor Fichtinger · 2019
PURPOSE: Partial nephrectomy is the preferred method for managing small renal masses. This procedure has significant advantages over radical nephrectomy. However, partial nephrectomy is under-used due to its difficulty. We propose a navigation system for laparoscopic partial nephrectomy. In this study, we evaluate the usability and accuracy of the navigation system. METHODS: An electromagnetically tracked navigation system for partial nephrectomy was developed. This system tracks the positions of the laparoscopic scissors, ultrasound probe, tumor, and calyces and vasculature. Phantom kidneys were created using mixtures of plastisol and cellulose. To test the system, the navigation display quality was measured through measurement of lag and frames per second displayed. The accuracy of the system was determined through fiducial registration. Finally, a study consisting of ten participants was conducted to assess the usability of the navigation system using the System Usability Survey. RESULTS: The mean System Usability Score of the navigation system was 82.5. The navigation display had an average lag of 243 milliseconds and showed 5 frames per second. The accuracy was measured with fiducial registration and found to have an RMS error of 2.84 mm. CONCLUSION: The results of this study suggest that the partial nephrectomy navigation system developed is both usable and accurate. Future work will include the conversion of the laparoscopic scissor tool tracking to optical. Further studies will be conducted to determine the effectiveness of this technology in tumor resection and avoidance of calyx and vasculature damage. We will additionally explore this system as a training tool.