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图像引导手术在微创泌尿外科中的应用。

Image-guided surgery in minimally invasive urology.

机构信息

Urological Institute, University of Southern California, Los Angeles, California, USA.

出版信息

Curr Opin Urol. 2010 Mar;20(2):136-40. doi: 10.1097/MOU.0b013e3283362610.

Abstract

PURPOSE OF REVIEW

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.

RECENT FINDINGS

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.

SUMMARY

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.

摘要

目的综述

图像引导手术(IGS)是一种新型手术,间接可视化手术解剖结构有助于外科医生更精确、更安全地进行微创经皮、腹腔镜或机器人辅助治疗,实现肿瘤的完全切除和关键器官功能的保留。

最近的发现

尽管二维超声已作为常规术中图像引导发挥了主要作用,但超声与计算机断层扫描(CT)或磁共振成像(MRI)的图像融合系统、三维超声成像、兼容 MRI 的导航系统以及增强现实导航系统的图像叠加技术已经出现,并得到了计算机的辅助。软组织导航中增强现实的发展具有挑战性,特别是在器官运动和变形的跟踪方面。在 IGS 中,外科医生可以看到患者身体任何角度的断层图像,或者直接视野之外的 3D 解剖结构。IGS 不仅可以提供能量或药物输送到治疗靶点,还可以监测治疗的精确性和有效性。

总结

新兴的成像技术为外科医生提供了一个新的强大机会,使他们能够在直接视野之外了解手术病理目标和重要健康解剖结构的位置。

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