EAU 2018: Pre-operative planning and new visualization technologies in urology

Copenhagen, Denmark (UroToday.com) Dr. Rassweiller gave an overview on the advantages of preoperative and new visualization technologies in urology. He began the discussion with the application of navigation in urologic surgery. This includes robot assisted laparoscopy, endourology, needle biopsy and focal prostate cancer treatment. The current available technologies to assist urologists in preoperative planning include fluoroscopy, CT and MRI. Unfortunately, these modalities have significant limitations. For fluoroscopy – it is limited in its accuracy, and has handling problems, CT – has its inherent radiation exposure issues, and MRI is expensive and has handling issues. One of these new and enhanced navigation techniques include the utilization of 3D-CT simulation, which would be very helpful in preoperative planning. There has also been development of marker based navigation using the IPAD in kidney surgery.

When assessing the impact of navigation in needle biopsy, it is most evident in MRI-fusion biopsies of the prostate. Navigation is crucial in this procedure in all its steps, including pre-procedural planning, showing of 3d fusion model and real time TRUS during biopsy, and visualization and saving of biopsies performed in 3d- fusion model.

There has also ben advanced in the utilization of 3d printing in urological surgeries. This is now being utilized in prostate cancer to identify the tumor and predict extracapsular extension. This will hopefully result in the reduction of positive margins rate and assist in the dissection of the apex and bladder neck.

Speaker: J. Rassweiler, Heilbronn (DE), A. Dourado Meneses, Teresina (BR)

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark