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04-09-2021 | Artificial Intelligence | Review Article

The evolution of image guidance in robotic-assisted laparoscopic prostatectomy (RALP): a glimpse into the future

Authors: Joshua Makary, Danielle C. van Diepen, Ranjan Arianayagam, George McClintock, Jeremy Fallot, Scott Leslie, Ruban Thanigasalam

Published in: Journal of Robotic Surgery | Issue 4/2022

Abstract

Objectives

To describe the innovative intraoperative technologies emerging to aid surgeons during minimally invasive robotic-assisted laparoscopic prostatectomy.

Methods

We searched multiple electronic databases reporting on intraoperative imaging and navigation technologies, robotic surgery in combination with 3D modeling and 3D printing used during laparoscopic or robotic-assisted laparoscopic prostatectomy. Additional searches were conducted for articles that considered the role of artificial intelligence and machine learning and their application to robotic surgery. We excluded studies using intraoperative navigation technologies during open radical prostatectomy and studies considering technology to visualize lymph nodes.

Summary of findings

Intraoperative imaging using either transrectal ultrasonography or augmented reality was associated with a potential decrease in positive surgical margins rates. Improvements in detecting capsular involvement may be seen with augmented reality. The benefit, feasibility and applications of other imaging modalities such as 3D-printed models and optical imaging are discussed.

Conclusion

The application of image-guided surgery and robotics has led to the development of promising new intraoperative imaging technologies such as augmented reality, fluorescence imaging, optical coherence tomography, confocal laser endomicroscopy and 3D printing. Currently challenges regarding tissue deformation and automatic tracking of prostate movements remain and there is a paucity in the literature supporting the use of these technologies. Urologic surgeons are encouraged to improve and test these advanced technologies in the clinical arena, preferably with comparative, randomized, trials.

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Title: The evolution of image guidance in robotic-assisted laparoscopic prostatectomy (RALP): a glimpse into the future
Authors: Joshua Makary
Danielle C. van Diepen
Ranjan Arianayagam
George McClintock
Jeremy Fallot
Scott Leslie
Ruban Thanigasalam
Publication date: 04-09-2021
Publisher: Springer London
Keywords: Artificial Intelligence
Prostatectomy
Prostatectomy
Published in: Journal of Robotic Surgery / Issue 4/2022
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-021-01305-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The evolution of image guidance in robotic-assisted laparoscopic prostatectomy (RALP): a glimpse into the future

Abstract

Objectives

Methods

Summary of findings

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Summary of findings

Conclusion

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