To evaluate the feasibility of hyperaccuracy three-dimensional (HA3D) virtual models with augmented reality (AR) in robot-assisted retroperitoneal lymph node dissection (R-RPLND) for testicular cancer.
A 35-year-old male with 4 cm interaortocaval seminoma recurrence underwent unilateral template R-RPLND. A patient-specific HA3D model was generated from contrast-enhanced CT using Avatar Medical software and integrated into preoperative planning and intraoperative AR navigation.
HA3D modeling enabled precise preoperative identification of a critical renal arterial branch adjacent to the tumor, facilitating safe dissection. R-RPLND was completed in 76 min with minimal blood loss (30 mL) and no complications. Pathology confirmed 4.5 cm viable seminoma metastasis. Nine-month follow-up showed no recurrence.
This proof-of-concept case demonstrates successful integration of HA3D virtual models and AR into R-RPLND workflow, potentially enhancing anatomical visualization, surgical planning, and procedural safety. Multicenter prospective studies are needed to validate reproducibility and clinical benefit.
The international journal of medical robotics + computer assisted surgery : MRCAS. 2026 Jun [Epub]
Markus Angerer, Mattis Franke, Klaus-Peter Dieckmann, Christian Wülfing
Department of Urology, Asklepios Klinik Altona, Hamburg, Germany.