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International Journal of Computer Assisted Radiology and Surgery

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22.05.2019 | Original Article

Assessment of surgical skills by using surgical navigation in robot-assisted partial nephrectomy

verfasst von: Satoshi Kobayashi, Byunghyun Cho, Arnaud Huaulmé, Katsunori Tatsugami, Hiroshi Honda, Pierre Jannin, Makoto Hashizumea, Masatoshi Eto

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 8/2019

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Abstract

Purpose

To assess surgical skills in robot-assisted partial nephrectomy (RAPN) with and without surgical navigation (SN).

Methods

We employed an SN system that synchronizes the real-time endoscopic image with a virtual reality three-dimensional (3D) model for RAPN and evaluated the skills of two expert surgeons with regard to the identification and dissection of the renal artery (non-SN group, n = 21 [first surgeon n = 9, second surgeon n = 12]; SN group, n = 32 [first surgeon n = 11, second surgeon n = 21]). We converted all movements of the robotic forceps during RAPN into a dedicated vocabulary. Using RAPN videos, we classified all movements of the robotic forceps into direct action (defined as movements of the robotic forceps that directly affect tissues) and connected motion (defined as movements that link actions). In addition, we analyzed the frequency, duration, and occupancy rate of the connected motion.

Results

In the SN group, the R.E.N.A.L nephrometry score was lower (7 vs. 6, P = 0.019) and the time to identify and dissect the renal artery (16 vs. 9 min, P = 0.008) was significantly shorter. The connected motions of inefficient “insert,” “pull,” and “rotate” motions were significantly improved by SN. SN significantly improved the frequency, duration, and occupancy rate of connected motions of the right hand of the first surgeon and of both hands of the second surgeon. The improvements in connected motions were positively associated with SN for both surgeons.

Conclusion

This is the first study to investigate SN for nephron-sparing surgery. SN with 3D models might help improve the connected motions of expert surgeons to ensure efficient RAPN.

Vorheriger Artikel The hind- and midfoot alignment computed after a medializing calcaneal osteotomy using a 3D weightbearing CT

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Titel: Assessment of surgical skills by using surgical navigation in robot-assisted partial nephrectomy
verfasst von: Satoshi Kobayashi
Byunghyun Cho
Arnaud Huaulmé
Katsunori Tatsugami
Hiroshi Honda
Pierre Jannin
Makoto Hashizumea
Masatoshi Eto
Publikationsdatum: 22.05.2019
Verlag: Springer International Publishing
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 8/2019
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-019-01980-8

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Abstract

Purpose

Methods

Results

Conclusion

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