Image-guided surgery in minimally invasive urology

Abstract

Image-guided surgery (IGS) is a new type of surgery in which indirect visualization of the surgical anatomy helps the surgeon to enable minimally invasive percutaneous, laparoscopic, or robotic-aided treatment more precisely and safely, to achieve complete tumor removal and sparing of the function of critical organs. Although 2D ultrasonography has played a main role as conventional intraoperative image guidance, image-fusion system of ultrasonography with computed tomography (CT) or MRI, 3D ultrasonography imaging, MRI-compatible navigation system, and image-overlay technology of augmented reality navigation system have emerged with computer aid. Development of augmented reality in soft tissue navigation is challenging, especially in tracking of organ motion and deformation. In IGS, the surgeon may see any angled tomogram of the patient's body, or 3D anatomies beyond the direct vision. IGS would not only provide the delivery of energy or medicines to the therapeutic target, but also monitor the precision and effectiveness of the treatment. Emerging imaging technology gives surgeons a new powerful opportunity to realize where surgical pathological targets and vital healthy anatomies are located beyond the surgeon's direct vision.