1552 DEVELOPMENT OF A NAVIGATION SYSTEM USING A MAGNETIC TRACKING SYSTEM FOR URETEROSCOPY

Abstract

You have accessJournal of UrologyStone Disease: New Technology1 Apr 20131552 DEVELOPMENT OF A NAVIGATION SYSTEM USING A MAGNETIC TRACKING SYSTEM FOR URETEROSCOPY Kenji Yoshida, Gen Kawa, Hidefumi Kinoshita, and Tadashi Matsuda Kenji YoshidaKenji Yoshida Osaka, Japan More articles by this author , Gen KawaGen Kawa Osaka, Japan More articles by this author , Hidefumi KinoshitaHidefumi Kinoshita Osaka, Japan More articles by this author , and Tadashi MatsudaTadashi Matsuda Osaka, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3062AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current flexible ureteroscopes have smaller outer diameters and larger working channels. These improvements have allowed access to the entire intrarenal correcting system and also permitted urologists to efficiently treat upper urinary tract pathology. However, controlling a flexible ureteroscope require a certain level of expertise and it takes a lot of times and efforts to acquire the adequate skills. Novice operators sometimes lose the spatial orientation during examination in patients with complicated pyelocaliceal shapes. Therefore the perioperative navigation system would be useful for ureteroscopic treatment in upper urinary tract. In this study, we introduced our experimental model of ureteroscopic navigation system. METHODS Our navigation system uses a magnetic tracking system to detect the position of the sensor cord tip. Magnetic field generator detects the position and orientation of sensors within a defined dome-shaped volume. Cord with sensors passes through the endoscopic channel and position of tip and 8 cm from the tip were tracked in real time. The phantom model and 3-D images of the pyelocaliceal system were created from DICOM CT data obtained from a specific patient. The plaster phantom had an inner cavity to allow use of an endoscope and was fixed to an acrylic board in the magnetic field. The instrument tip position in the magnetic field was detected by calibration. To align the position of the pyelocaliceal phantom to 3D images, the corner of the acrylic board was adjusted using fiducial landmarks. RESULTS When passing an endoscope into the phantom, the tip position was displayed in 3D images. 3D images were displayed on the secondary monitor positioned next to the main monitor. Our navigation system accurately displayed the position of the ureteroscope in 3D images of the inside of the phantom (Figure). CONCLUSIONS Our navigation system could help to access to all calices of collecting system. It would increase the efficiency of stone removal and the chances of finding upper tract urothelial lesions. This system can also be used as a training system for novice endoscopists to acquire fundamental skills and has a possibility to reduce fluoroscopy time. To use our system clinically, the sensor must be built into the endoscope shaft and this is an area of future research. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e637 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenji Yoshida Osaka, Japan More articles by this author Gen Kawa Osaka, Japan More articles by this author Hidefumi Kinoshita Osaka, Japan More articles by this author Tadashi Matsuda Osaka, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...