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

Curr Opin Urol. 2018 Mar;28(2):205-213. doi: 10.1097/MOU.0000000000000478.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diagnostic Imaging / methods
  • Humans
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*
  • Surgery, Computer-Assisted / trends
  • Urologic Diseases / surgery*
  • Urologic Surgical Procedures / instrumentation
  • Urologic Surgical Procedures / methods*
  • Urologic Surgical Procedures / trends
  • Virtual Reality*