title: Integrated image navigation system using head-mounted display in "RoboSurgeon" endoscopic radical prostatectomy.
abstract: The safety and efficacy of minimally invasive surgery relies on visual information. We aimed to develop an integrated image navigation system (RoboSurgeon System) that combines head-mounted displays (HMDs) with multiple image modalities, and assessed its feasibility in 5 prostate cancer patients who underwent gasless single-port endoscopic radical prostatectomy. A robotically manipulated transrectal ultrasound (TRUS) system was used. In all cases, preoperative magnetic resonance (MR) images and intraoperative real-time images of an endoscope, TRUS, and HMD-mounted camera were integrated and displayed synchronously on each HMD in a four-split screen mode during the entire process. The TRUS helped identify the boundary with the adjacent structures endoscopically in reference to MR images. There were no negative incidents in intraoperative or postoperative courses. Integrated image navigation using HMDs as individualized monitors is feasible in the natural ergonomic position and may be beneficial to identify correct dissection planes. The efficacy of the RoboSurgeon System deserves further evaluation.
authors.affiliation: Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
authors.affiliation: Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawashima
authors.affiliation: Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
keywords: head-mounted display; image navigation; minimally invasive surgery; prostate cancer; radical prostatectomy; transrectal ultrasound