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Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation.

Philippa Meershoek ,
Matthias N van Oosterom ,
Hervé Simon ,
Laurent Mengus ,
Tobias Maurer ,
Pim J van Leeuwen ,
Esther M K Wit ,
Henk G van der Poel ,
Fijs W B van Leeuwen

Abstract

METHODS

Ten patients scheduled for a sentinel node procedure received four injections into the prostate with (indocyanine green-)99mTechnetium-nanocolloid and underwent preoperative imaging (lymphoscintigraphy and SPECT/CT). The DROP-IN probe was inserted via the assistant port, still permitting the insertion and usage of additional laparoscopic tools.

CONCLUSIONS

Overall the DROP-IN design proves to be a valuable tool for robot-assisted radioguided surgery approaches.

RESULTS

The sentinel nodes were resected using the da Vinci® Si robot under guidance of DROP-IN gamma tracing and fluorescence imaging. The surgeon was able to independently maneuver the DROP-IN probe using the ProGrasp® forceps of the da Vinci® robot and distinguish sentinel nodes from background signal (such as the injection site).

PURPOSE

Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed. Here we present the first in vivo feasibility study of this technology in prostate cancer patients.

More about this publication

European journal of nuclear medicine and molecular imaging

Volume 46
Issue nr. 1
Pages 49-53
Publication date 01-01-2019

Full text links

Publisher website (DOI) 10.1007/s00259-018-4095-z
Europe PubMed Central 30054696
Pubmed 30054696

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