AR surgical navigation development and clinical introduction in robot-assisted partial nephrectomy

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K20713
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 90130:Medical systems-related
• Research Institution: Kyushu University
• Principal Investigator: Cho Byunghyun 九州大学, 先端医療オープンイノベーションセンター, 特任助教 (20734528)
• Project Period (FY): 2019-04-01 – 2021-03-31
• Keywords: ロボット支援腎部分切除術 / ナビゲーション / 仮想現実 / 拡張現実

Outline of Final Research Achievements

Nephron-sparing surgery, such as robot-assisted partial nephrectomy (RAPN), for small renal tumors has been reported to yield excellent functional and oncological outcomes. While RAPN is becoming one of the standard treatments, the procedure is becoming more complex as it requires surgeons to resect the tumor and suture the kidney surface within the limited warm ischemic time (WIT) as quickly as possible after identifying and clamping the renal artery. In this study, we employed an surgical system during RAPN
that synchronizes real-time endoscopic images with a 3D model in virtual reality (VR). We assessed whether this image-support system improves the surgical procedure by focusing on connected motions at the phase of identifying a renal artery. These results were reported to The 71st Annual Meeting of West Japan Urological Association, The 32nd Annual Congress of Japan Society for Endoscopic Surgery, The 30th kyushu Society and Endoscopic and Robotic Surgery and CARS2019.

Free Research Field

医療画像処理

Academic Significance and Societal Importance of the Research Achievements

本研究では、小径腎癌に対してロボット支援腎部分切除術(RAPN)における内視鏡画像上では脂肪や腎実質に埋もれた腎動脈や腫瘍を3D画像で可視化するため、拡張現実を使用したロボットの手術ナビゲーションシステムを開発している。内視鏡に各々装着し光学式追跡システムで内視鏡の動き(位置情報)を計測し、その情報をベースに3画像を自動で動かし、かつ内視鏡画像にその3D画像を重畳させ、術者はコンソール（Tile Pro）内に画像提示された３D情報をフィードバックすることでより安全・安心で手術を行うことができ、時間短縮などで合併症の低減に貢献できると期待される。