Abstract
Holmium Laser Enucleation of the Prostate (HoLEP) is an endoscopic transurethral surgical technique for Benign Prostatic Hyperplasia (BPH) treatment that carries significant benefits compared with the traditional Trans-Urethral Resection of the Prostate (TURP). In HoLEP procedure the portion of the prostate with hyperplasia (adenoma) is cut under endoscopic view. Only a few experts in the world perform HoLEP, since the adenoma borders are not clearly visible in the 2D endoscopic images and consequently the clinicians have difficulties to orientate the laser.
Virtual reality navigators demonstrated their potentialities in many fields of surgery to show hidden structures to direct vision and to restore surgeon’s orientation.
3D trans-rectal ultrasound (US) probe allows acquiring volumetric information containing prostate and adenoma borders, which can be segmented and represented in a virtual environment. To coherently and real-time render the surgical instrument in respect to the patient anatomy, we can employ a tracking system. A crucial aspect of each navigation system regards the virtual scene ergonomics.
We designed and implemented a pilot surgical navigation system to support the surgeons to accomplish the HoLEP, showing them the cutting plane and the outlines of adenoma and the prostatic capsule in respect of the surgical tool.
Under supervision of an expert urologist we studied and tested the optimal way to realize an anthropomorphous US phantom. Furthermore our virtual reality surgical navigator provides various visualization modalities studied on the basis of clinical requirements.
On the basis of our results it will be possible to perform in-vitro trails to evaluate the usability of our solution to precisely enucleate the adenoma along its borders.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Medersbacher and Marberger: Is transurethral resection of the prostate still justified? BJU International 83, 227–237 (1999)
Leyh and Necknig: Transurethral prostatectomy: management of complications. Urologe A. 53(5), 699–705 (2014). doi:10.1007/s00120-014-3483-7
Reich, O., Gratzke, C., Bachmann, A., Seitz, M., Schlenker, B., Hermanek, P., Lack, N., Stief, C.G.: Morbidity, Mortality and Early Outcome of Transurethral Resection of the Prostate:A Prospective Multicenter Evaluation of 10,654 Patients. J Urol 180(1), 246–249
Horninger, W., Unterlechner, H., Strasser, H., Bartsch, G.: Transurethral prostatectomy: mortality and morbidity. Prostate 28, 195–200 (1996)
Gilling, P.J., Cass, C.B., Cresswell, M.D., Fraundorfer, M.R.: Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 47(1), 48–51 (1996a)
Cynk, M.: Holmium laser enucleation of the prostate: a review of the clinical trial evidence. Ther Adv Urol. 6(2), 62–73 (2014). doi:10.1177/1756287213511509
Gilling, P.J., Cass, C.B., Cresswell, M.D., Malcolm, A.R., Fraundorfer, M.R.: The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol. 10(5), 459–461 (1996b)
Megali, G., Ferrari, V., et al.: EndoCAS navigator platform: a common platform for computer and robotic assistance in minimally invasive surgery. Int J Med Robot Comp 4(3), 242–251 (2008)
Freschi, C., Troia, E., et al.: Ultrasound Guided Robotic Biopsy Using Augmented Reality and Human-Robot Cooperative Control. Conf Proc IEEE Eng Med Biol Soc 2009, 5110–5113 (2009)
Zell, K., Sperl, J.I., Vogel, M.W., Niessner, R., Haisch, C.: Acoustical properties of selected tissue phantom materials for ultrasound imaging. Physics in medicine and biology 52, N475–N484 (2007)
Ahmadi, R., Kalbasi-Ashtari, A., Oromiehie, A., Yarmand, M.S., Jahandideh, F.: Development and characterization of a novel biodegradable edible film obtained from psyllium seed (Plantago ovata Forsk). J Food Eng 109, 745–751 (2012)
Wilkin, R., Hamm, R.: How to make a cheap and simple prostate phantom. J Ultrasound Med 29, 1151–1152 (2010)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this paper
Cite this paper
Lo Presti, G., Freschi, C., Sinceri, S., Morelli, G., Ferrari, M., Ferrari, V. (2014). Virtual Reality Surgical Navigation System for Holmium Laser Enucleation of the Prostate. In: De Paolis, L., Mongelli, A. (eds) Augmented and Virtual Reality. AVR 2014. Lecture Notes in Computer Science(), vol 8853. Springer, Cham. https://doi.org/10.1007/978-3-319-13969-2_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-13969-2_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-13968-5
Online ISBN: 978-3-319-13969-2
eBook Packages: Computer ScienceComputer Science (R0)