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Computer-assisted surgery: virtual- and augmented-reality displays for navigation during urological interventions

van Oosterom, Matthias, N.a,b; van der Poel, Henk, G.c; Navab, Nassird,e; van de Velde, Cornelis, J.H.b; van Leeuwen, Fijs, W.B.a,c

doi: 10.1097/MOU.0000000000000478
IMAGE GUIDED DIAGNOSTICS AND THERAPY IN UROLOGIC CANCERS: Edited by Tobias Maurer and Declan Murphy

Purpose of review To provide an overview of the developments made for virtual- and augmented-reality navigation procedures in urological interventions/surgery.

Recent findings Navigation efforts have demonstrated potential in the field of urology by supporting guidance for various disorders. The navigation approaches differ between the individual indications, but seem interchangeable to a certain extent. An increasing number of pre- and intra-operative imaging modalities has been used to create detailed surgical roadmaps, namely: (cone-beam) computed tomography, MRI, ultrasound, and single-photon emission computed tomography. Registration of these surgical roadmaps with the real-life surgical view has occurred in different forms (e.g. electromagnetic, mechanical, vision, or near-infrared optical-based), whereby the combination of approaches was suggested to provide superior outcome. Soft-tissue deformations demand the use of confirmatory interventional (imaging) modalities. This has resulted in the introduction of new intraoperative modalities such as drop-in US, transurethral US, (drop-in) gamma probes and fluorescence cameras. These noninvasive modalities provide an alternative to invasive technologies that expose the patients to X-ray doses. Whereas some reports have indicated navigation setups provide equal or better results than conventional approaches, most trials have been performed in relatively small patient groups and clear follow-up data are missing.

Summary The reported computer-assisted surgery research concepts provide a glimpse in to the future application of navigation technologies in the field of urology.

aInterventional Molecular Imaging Laboratory, Department of Radiology

bDepartment of Surgery, Leiden University Medical Center, Leiden

cDepartment of Urology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

dComputer Aided Medical Procedures (CAMP), Technische Universität München, Institut für Informatik, Garching bei München, Germany

eComputer Aided Medical Procedures (CAMP), Johns Hopkins University, Baltimore, Maryland, USA

Correspondence to Fijs W.B. van Leeuwen, Interventional Molecular Imaging Laboratory, Department of Radiology, C2-S zone, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. Tel: +31 71 526 6029; e-mail: f.w.b.van_leeuwen@lumc.nl

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