Laparoscopic radical nephrectomy under near real-time three-dimensional surgical navigation with C-arm cone beam computed tomography.
OBJECTIVE
The aim of this study was to demonstrate the advantages of C-arm cone beam computed tomography for imaging guidance of laparoscopic radical nephrectomy (LRN).


METHODS
Four patients referred to the authors' institution for LRN were included in this study. To visualize the renal vascular anatomy, the Iopamiron 300 contrast agent was injected intravenously. The surgeon could adjust the viewing angle of the images and rotate the reconstructed three-dimensional (3D) image manually by using a mouse-like controller. Using the near real-time 3D navigation images, the surgeon was able to recognize the renal vascular anatomy, and more easily perform the LRN.


RESULTS
All procedures were successfully performed with a satisfactory diagnostic yield or therapeutic effect without procedure-related complications.


CONCLUSIONS
This novel technology has great potential for application in LRN because it enables accurate depiction of the renal vessels and increases surgeon confidence.
Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan. nozaki0921@yahoo.co.jp
Tetsuo
T
Nozaki
Yasuhiro
Y
Iida
Akihiro
A
Morii
Yasuyoshi
Y
Fujiuchi
Hideki
H
Fuse
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007668:Kidney / Q000098:blood supply; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*