Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation
Abstract
PURPOSE: Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed. Here we present the first in vivo feasibility study of this technology in prostate cancer patients.
METHODS: Ten patients scheduled for a sentinel node procedure received four injections into the prostate with (indocyanine green-)99mTechnetium-nanocolloid and underwent preoperative imaging (lymphoscintigraphy and SPECT/CT). The DROP-IN probe was inserted via the assistant port, still permitting the insertion and usage of additional laparoscopic tools.
RESULTS: The sentinel nodes were resected using the da Vinci® Si robot under guidance of DROP-IN gamma tracing and fluorescence imaging. The surgeon was able to independently maneuver the DROP-IN probe using the ProGrasp® forceps of the da Vinci® robot and distinguish sentinel nodes from background signal (such as the injection site).
CONCLUSIONS: Overall the DROP-IN design proves to be a valuable tool for robot-assisted radioguided surgery approaches.
Bibliographical data
Original language | English |
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ISSN | 1619-7070 |
DOIs | |
Publication status | Published - 01.2019 |
Externally published | Yes |
PubMed | 30054696 |
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