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Techniques in Coloproctology

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01-06-2018 | Multimedia Article

Novel multi-image view for neuromapping meets the needs of the robotic surgeon

Authors: Jonas F. Schiemer, Lennart Zimniak, Edin Hadzijusufovic, Hauke Lang, Werner Kneist

Published in: Techniques in Coloproctology | Issue 6/2018

Abstract

Background

Pelvic intraoperative neuromonitoring during nerve-sparing robot-assisted total mesorectal excision (RTME) is feasible. However, visual separation of the neuromonitoring process from the surgeon console interrupts the workflow and limits the usefulness of available information as the procedure progresses. Since the robotic surgical system provides multi-image views in the surgeon console, the aim of this study was to integrate cystomanometry and internal anal sphincter electromyography signals to aid the robotic surgeon in his/her nerve-sparing technique.

Methods

We prospectively investigated 5 consecutive patients (1 male, 4 females) who underwent RTME for rectal cancer at our institution in 2017. The robotic surgery was performed using the da Vinci Xi combined with pelvic intraoperative neuromapping with real-time electromyography and cystomanometry signal transmission by multi-image view during RTME.

Results

The adapted two-dimensional pelvic intraoperative neuromonitoring imaging successfully simulcasted to the surgeon console view in all 5 cases. The technical note is complemented by an intraoperative video.

Conclusions

This report demonstrates the technical feasibility of an improved neuromonitoring process during nerve-sparing RTME. Robotic neuromapping can be fully visualized from the surgeon console.

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Title: Novel multi-image view for neuromapping meets the needs of the robotic surgeon
Authors: Jonas F. Schiemer
Lennart Zimniak
Edin Hadzijusufovic
Hauke Lang
Werner Kneist
Publication date: 01-06-2018
Publisher: Springer International Publishing
Published in: Techniques in Coloproctology / Issue 6/2018
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-018-1804-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Novel multi-image view for neuromapping meets the needs of the robotic surgeon

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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