Furukawa Junya, Miyake Hideaki, Tanaka Kazushi, Sugimoto Maki, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, Japan.
Int J Med Robot. 2014 Dec;10(4):385-90. doi: 10.1002/rcs.1574. Epub 2014 Feb 26.
The objective of this study was to describe our early experience with robot-assisted partial nephrectomy (RAPN) incorporating selective arterial clamping, using an image overlay navigation system.
Three-dimensional images were reconstructed from computed tomography using open source processing software, OsiriX, and were directly visualized on the screen of a da Vinci surgeon's console with TilePro multi-input display functions. Using this imaging system, RAPN with selective arterial clamping was performed in 17 patients with renal tumours.
The intraoperative image overlay navigation system made it possible to clearly show the tumour position and vascular supply within the console's field of view, and facilitate selective arterial clamping during RAPN, resulting in a mean decrease in estimated glomerular filtration rates at both 1 and 4 weeks after RAPN < 10 ml/min/1.73 m(2) .
RAPN with selective arterial clamping using this innovative imaging system could be a useful alternative to conventional RAPN.
本研究的目的是描述我们使用图像叠加导航系统进行机器人辅助部分肾切除术（RAPN）并结合选择性动脉夹闭的早期经验。
使用开源处理软件OsiriX从计算机断层扫描重建三维图像，并通过TilePro多输入显示功能直接在达芬奇外科医生控制台的屏幕上可视化。使用该成像系统，对17例肾肿瘤患者进行了选择性动脉夹闭的RAPN。
术中图像叠加导航系统能够在控制台视野内清晰显示肿瘤位置和血管供应，并有助于RAPN期间的选择性动脉夹闭，导致RAPN后1周和4周时估计肾小球滤过率平均下降<10 ml/min/1.73 m²。
使用这种创新成像系统进行选择性动脉夹闭的RAPN可能是传统RAPN的一种有用替代方法。
