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Image-guided surgery in minimally invasive urology

Ukimura, Osamua,b

doi: 10.1097/MOU.0b013e3283362610
Update on laparoscopic and robot-assisted laparoscopic surgery in urology: Edited by Inderbir S. Gill

Purpose of review Image-guided surgery (IGS) is a new type of surgery in which indirect visualization of the surgical anatomy helps the surgeon to enable minimally invasive percutaneous, laparoscopic, or robotic-aided treatment more precisely and safely, to achieve complete tumor removal and sparing of the function of critical organs.

Recent findings Although 2D ultrasonography has played a main role as conventional intraoperative image guidance, image-fusion system of ultrasonography with computed tomography (CT) or MRI, 3D ultrasonography imaging, MRI-compatible navigation system, and image-overlay technology of augmented reality navigation system have emerged with computer aid. Development of augmented reality in soft tissue navigation is challenging, especially in tracking of organ motion and deformation. In IGS, the surgeon may see any angled tomogram of the patient's body, or 3D anatomies beyond the direct vision. IGS would not only provide the delivery of energy or medicines to the therapeutic target, but also monitor the precision and effectiveness of the treatment.

Summary Emerging imaging technology gives surgeons a new powerful opportunity to realize where surgical pathological targets and vital healthy anatomies are located beyond the surgeon's direct vision.

aUrological Institute, University of Southern California, Los Angeles, California, USA

bDepartment of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan

Correspondence to Osamu Ukimura, MD, PhD, University of Southern California, USC/Norris Cancer Center, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA, 90089 USA Tel: +1 323 865 3707; fax: +1 323 865 0120; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.