PD4-01 NOVEL NAVIGATION SYSTEM INTEGRATING GPS TECHNOLOGY WITH MOVABLE TABLET DISPLAY OF SURGICAL 3D MODEL FOR PERCUTANEOUS INTERVENTION

Abstract

You have accessJournal of UrologyImaging/Radiology I1 Apr 2014PD4-01 NOVEL NAVIGATION SYSTEM INTEGRATING GPS TECHNOLOGY WITH MOVABLE TABLET DISPLAY OF SURGICAL 3D MODEL FOR PERCUTANEOUS INTERVENTION Osamu Ukimura, Andre Luis de Cadtro Abreu, Arnaud Marien, Sunao Shoji, Toru Matsugasumi, Raed Azhar, Mihir Desai, and Inderbir Gill Osamu UkimuraOsamu Ukimura More articles by this author , Andre Luis de Cadtro AbreuAndre Luis de Cadtro Abreu More articles by this author , Arnaud MarienArnaud Marien More articles by this author , Sunao ShojiSunao Shoji More articles by this author , Toru MatsugasumiToru Matsugasumi More articles by this author , Raed AzharRaed Azhar More articles by this author , Mihir DesaiMihir Desai More articles by this author , and Inderbir GillInderbir Gill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.222AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We present the first application of a percutaneous navigation system (Translucent™ Medical, Inc.) which integrates GPS technology with a movable tablet display of virtual 3D models. Both the surgical tools and the movable tablet display are tracked by GPS technology and digitally aligned with each other. In real-time, this system displays the internal anatomy, superimposed surgical tools, and navigation aids (such as predicted puncture line). The objective of our study was to assess the feasibility and accuracy of this system in a cadaver model for targeted interventions of the prostate and kidney. METHODS Gold fiducial-markers (CIVCO Medical), which served as target center of the virtual tumor (Target-fiducial), were needle-implanted in kidney and prostate parenchyma. Then a pre-operative CT scan was obtained, and CT-DICOM data were transferred to the system to construct 3D surgical models. A needle, with built-in GPS sensors, was used as the therapeutic puncture needle. When the system indicated coincidence of the needle-tip and target-fiducial, another gold fiducial (Treatment-fiducial) was placed through the outer-sheath of the therapeutic needle. A post-operative CT was acquired to measure distance between the Target and Treatment fiducials. For each Target-fiducial, two placements of a Treatment-fiducial were attempted (from two different skin incisions >2 cm apart). RESULTS Real-time display of the needle puncture trajectory superimposed on the 3D model allowed successful navigation in all procedures. Navigation was further enhanced by color-coded changes to the needle-icon, which indicated whether or not the current trajectory was on-track to intersect the surgical target. Median time to target was 43 sec. Mean distance from needle-tip to target was 2.5mm (as calculated by the tracking system). Distance between the Target- and Treatment-fiducial was 16.6 mm in the prostate and 12 mm in the kidney. Distance between the paired Treatment-fiducials was 7.7mm. Analyzing each axial component, errors were significantly greater along z-axis (p<0.01), likely due to the intra-operative compression of the organ during puncture, resulting in possible rotation, shift, or deformation of the soft-tissue cadaveric organ. CONCLUSIONS This virtual navigation system, integrating GPS-technology with movable tablet display, is promising for percutaneous interventions. In order to minimize possible errors, further work is needed to augment the tracking system for intra-corporeal organ motion/deformation. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e51 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Osamu Ukimura More articles by this author Andre Luis de Cadtro Abreu More articles by this author Arnaud Marien More articles by this author Sunao Shoji More articles by this author Toru Matsugasumi More articles by this author Raed Azhar More articles by this author Mihir Desai More articles by this author Inderbir Gill More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...