Selective Clamping for Robot-Assisted Surgical Procedures.

Partial nephrectomy, the gold standard treatment for renal tumors, is performed with clamping of the renal arteries, in order to interrupt the blood flowing towards the tumor. However, the temporary interruption of arterial flow may lead to ischemia of the renal parenchyma. Thus, the interruption of the flow should be as short as possible and the clamping should be localized to the arteries flowing towards the tumor only, by implementing the so-called selective clamping. In this paper, we propose a system to automatically provide to the surgeon the optimal clamping points, according to our methods, which allow to minimize the ischemia percentage, thus preserving the health of the remaining renal parenchyma. Moreover, we exploit the algorithm as a planner for a robotic system that, starting from the clamping points automatically computed, emulates the clamping procedure. The overall architecture is validated on different patient's anatomies and using a robotic setup.