Category: New Technology: Laparoscopy & Robotics

VS5-3 - Surgical Navigation in robot-assisted partial nephrectomy improve operative duration and surgical skills.

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Robot-Assisted partial nephrectomy(RAPN) is one of the standard treatment for a small renal cancer. As the number of RAPN increases, the amount of complex surgeries such as highly complex tumor is increasing, as well. Sharing information about surgical plans and in-process surgeries is one of the most important things for safe and reliable surgery. That is why we have developed surgical navigation with automatic tracking system. In this study, to evaluate the clinical effectiveness of this system for RAPN.


Methods :

We have developed the program which synchronized the endoscopic movement with 3D models. And we could integrate endoscope’s positional information into a 3D model from contrast tomography by calculating the endoscopic position with an optical tracking system(Figure1, 2). We have introduced our surgical navigation for RAPN from September 2016 and we evaluated the effectiveness by subdividing operative duration into 3 phases; renal artery phase, renal tumor phase and resection and suturing phase.For evaluation of the influence on each surgeon’s skill by using surgical navigation, we translated the movement of all forceps into language and converted surgical processing models. Among many forceps movement, we could consider about forceps idling movement. 


Results :

The time to dissect a renal artery (WOSN, WSN, 10min30sec, 3min21sec, p=0.009) during the transperitoneal approach and the time to identify a renal artery (4min14sec, 57sec, p=0.003) during the retroperitoneal approach were shortened in surgical navigation group and were positively associated with shortening operative duration (p=0.039, 0.031). About monopolar forceps during the transperitoneal approach, surgeon No.1 improved rotating, inserting and pulling downtime (p=0.013, 0.045, 0.013) between forceps movement significantly and surgical navigation was positively associated with surgical skills improved. About monopolar during the retroperitoneal approach, inserting downtime (p=0.037) was improved. About each forceps during the transperitoneal approach, surgeon No.2 improved almost forceps movement frequency, duration and downtime significantly by using surgical navigation and surgical navigation was positively associated with surgical skills improved.


Conclusions : We have developed the surgical navigation system for RAPN, and this system might be possible to improve operative duration and surgical skills.

Satoshi Kobayashi

Graduate student, M.D.
Kyushu University, Department of Urology
Fukuoka, Fukuoka, Japan

My name is Satoshi Kobayashi and I'm a graduate student in Kyushu University, Japan. I'm also urolodist and work as medical engeneer.
I'm very intersted in development of new techinique for robotic surgery and I hope to apply for clinical cases. I am looking for a destination to study abroad. If you have some interesting in me, please contact me.

kobayashi.satoshi.282@m.kyushu-u.ac.jp

Byunghyun Cho

Ph.D.
Center for Advanced Medical Innovation
Fukuoka, Fukuoka, Japan

Katsunori Tatsugami

Associate proffer, M.D., Ph.D.
Kyushu University, Departmene of Urology
Fukuoka, Fukuoka, Japan

Arnaud Huaulmé

Ph.D.
University of Rennes 1
Ile-et-Vilaine, Ile-de-France, France

Pierre Jannin

Professor
University of Rennes 1
Rennes, Ile-de-France, France

Makoto Hasizume

Professor, M.D., Ph.D., FACS
Center for Advanced Medical Innovation
Fukuoka, Fukuoka, Japan

Masatoshi Eto

Professor, M.D.Ph.D.
Kyushu University Hospital, Department of Urology
Fukuoka, Fukuoka, Japan