PURPOSE - To guide the surgeon during laparoscopic or robot-assisted radical prostatectomy, an innovative laparoscopic/ultrasound fusion platform was developed, using a motorized 3D-transurethral ultrasound (TUUS) probe.
The first preclinical evaluation of 3D-prostate visualization using TUUS and preliminary results of this new augmented reality are here presented.
METHOD - The transurethral probe and laparoscopic/ultrasound registration were tested on realistic prostate phantoms made of standard polyvinyl chloride (PVC). Quality of TUUS images and detection of passive markers placed on the prostate's surface were evaluated on 2D-dynamic view and 3D-reconstruction. Secondly, an evaluation of the feasibility, precision and reproducibility of laparoscopic/TUUS registration was conducted using 4, 5, 6 and 7 markers to assess the optimal amount necessary. A Root Mean Square (RMS) error was obtained for each registration. Median RMS error with interquartile ranges (IQR) were calculated according to the number of markers RESULTS: TUUS was easy to manipulate and prostatic capsule well visualized in both 2D and 3D. Passive markers could precisely be localized in the volume. Laparoscopic/TUUS registration procedures were performed on 74 phantoms of various sizes and shape. All were successful, median RMS error was 1. 1 mm (IQR: 0. 8-1. 4) and significantly associated to the number of landmarks (p=0. 001), with the highest accuracy using 6 markers. Prostate volume, however, did not have an effect on the registration's precision.
CONCLUSION - TUUS provided high-quality prostate reconstructions and easy markers' detection. Laparoscopic/ultrasound registration was successful with an acceptable millimetric precision. Further investigations are necessary to achieve sub-millimetric accuracy and assess the feasibility in a human model.
The Journal of urology. 2016 Jan 25 [Epub ahead of print]
C Lanchon, G Custillon, A Moreau-Gaudry, J-L Descotes, J-A Long, G Fiard, S Voros
Urology Department, Grenoble University Hospital, Grenoble, France; UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France. , UJF-Grenoble 1, CNRS, TIMC-IMAG UMR 5525, 38041 Grenoble, France. , UJF-Grenoble 1, CNRS, TIMC-IMAG UMR 5525, 38041 Grenoble, France; Centre d'Investigation Clinique, Innovation Technologique, INSERM, CHU de Grenoble, UJF-Grenoble 1, CIT803, 38041 Grenoble, France. , Urology Department, Grenoble University Hospital, Grenoble, France; UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France. , Urology Department, Grenoble University Hospital, Grenoble, France; UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France. , Urology Department, Grenoble University Hospital, Grenoble, France; UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France. , UJF-Grenoble 1, CNRS, INSERM, TIMC-IMAG UMR 5525, 38041 Grenoble, France.