Smarther MRI. Novel Software Generates 3d Renderings of Fibroid Uterus for Preoperative Surgical Planning and Intraoperative Approach.

Abstract

<h3>Study Objective</h3> To compare the effects of conventional MRI and 3D Smart MRI for myomectomies by evaluating operative times, conversion rates, bleeding. A secondary objective is to compare patient satisfaction and perceived understanding of surgery for pre-surgical counseling. <h3>Design</h3> Use hospitalization records on patients who underwent myomectomies with standard MRI and collect data on the length of the case, EBL, conversion rate. This will be compared with the same measures in patients where 3D Smart MRI was employed to render anatomy adapted from coronal, sagittal, and axial 2D MRI imaging. The operating surgeons in both arms will be qualified MIGS surgeons. For our secondary objective, we design patient questionnaire for patients undergoing myomectomies using the standard 2D MRI during pre-surgical counseling and comparing it to the questionnaire of patients counseled with 3D Smart MRI renderings. The questionnaire will gauge patient ‘s understanding of the amount/size of the fibroids, their understanding of the procedure, and their satisfaction of pre-surgical counseling. <h3>Setting</h3> Major Academic Medical Center. <h3>Patients or Participants</h3> Population consist of 90 patients who have undergone or will undergo a laparoscopic and/or robot-assisted myomectomy, with 45 patients receiving conventional pre-surgical MRI and 45 patients receiving 3D Smart MRI. <h3>Interventions</h3> Primary endpoints: Operative time, blood loss, and conversion rate from laparoscopic to open surgery, in patients whose pre-surgical and/or intra-operative imaging consultation was a standard MRI or Smart MRI technology. The three primary endpoints will be compared between the two MRI modalities. Secondary endpoints: Patient satisfaction with pre-surgical counseling and patient perceived pre-surgical understanding in each of the two MRI groups. <h3>Measurements and Main Results</h3> TBD. <h3>Conclusion</h3> Hypothetically, 3D imaging of the leiomyomatous uterus with relationships of fibroids to one another and surrounding organs could help plan and execute surgical techniques more efficiently, leading to shorter operative times, less blood loss, fewer complications, and more complete excisions of myomas.