In laparoscopic surgery, endoscopy has to replace natural vision and tactile sensing. But the anatomy of the abdomen changes during surgery, and navigating based on preoperative images of the tumor is challenging. Intraoperative syngo DynaCT 3D imaging addresses this challenge. It provides a precise, up-to-date representation of the anatomy which can be fused with segmented MRI or CT images acquired preoperatively.
3D imaging also improves precision and safety in kidney stone therapy.
Tumor resection
Intraoperative 3D imaging for minimally-invasive liver resection
In minimally-invasive liver resection under endoscopy, the surgeon faces the challenge that the preoperative anatomical situation depicted in the MRI or CT images does not match the intraoperative situation and that tactile sensing due to the approach is impaired. The procedure planning that has been done based on these images thus does not precisely visualize the situation at hand any more. The solution to this challenge is intraoperative 3D imaging using syngo Large Volume DynaCT with subsequent image fusion using using syngo 3D Roadmap.
A 3D acquisition of the liver is thereby taken in the operating room after the CO2 inflation of the abdomen. The preoperative MR images are registered with the intraoperative 3D image and are then overlaid on live fluoroscopy. Through this overlay, the preoperative image is continuously being adapted to the current situation.
An integrated guidance application, syngo 3D Roadmap, then helps to navigate the instruments through this up-to-date 3D image and precisely resect the malign part of the organ, which has been marked in the data volume prior to surgery and is now clearly visible under fluoroscopy.
Watch the whole procedure as performed at the German Cancer Research Center, University Hospital Heidelberg
Partial nephrectomy
3D image guidance for partial nephrectomy
An important goal in partial nephrectomy is to spare as much healthy tissue as possible and to avoid ischemia or reduce it to a minimal time.
To achieve this, the surgeon needs to precisely locate the tumor and thereby faces the challenge that the preoperative anatomical situation depicted in the MRI or CT images does not match the intraoperative situation and that tactile sensing due to the minimally-invasive approach is impaired.
The procedure planning that has been done based on these images thus does not exactly visualize the situation at hand any more. The solution to this challenge is intraoperative 3D imaging using syngo DynaCT
PCNL
syngo DynaCT - guided kidney stone therapy (PCNL)
Patient safety is the guiding principle in kidney stone therapy. This means both the best possible therapeutical outcome and the lowest radiation dose possible. Safe and precise support for the puncture of the kidney and avoidance of second treatments after an incomplete PCNL, when small fragments of kidney stones are left in the renal calices, is the way to achieve this.
This is where syngo DynaCT finds its place in Endourology. Prof. Michel and his team at the University Hospital Mannheim have chosen an Artis zee ceiling system to fulfill their requirements for better interventional image quality and reductions in radiation exposure to both the patient and the urologist.
3D imaging during PCNL helps them find even very small stone fragments in the renal calcices. Integrated needle guidance with syngo Needle Guidance and a laser cross-hair on the detector aid in planning trajectories to precisely puncture the kidney.
The system thereby allows easy patient access as well as steep angulations necessary for treating obese patients.
Read more
Medical Knowledge Corner
Explore our collection of case studies, clinical workflows, videos, brochures and scientific publications for laparoscopic surgery.
Videos
Multiply your Senses - Abdomen (Teaser)
Multiply your Senses - Abdomen
Multiply your Senses - Abdomen (Case)
PCNL using syngo DynaCT (case)
3D-2D overlay with syngo iPilot during liver resection
DynaCT - Kidney
First minimally invasive liver resection with Artis zeego
First minimally invasive liver resection with Artis zeego (interview)
Minimally invasive navigated adrenalectomy using the Artis zeego and endoscopy fusion with 2D and 3D angiography
3D-guided laparoscopy with image fusion - Artis zeego
Image-Guided Laparoscopic Cryoablation
Customer Magazine
- AXIOM Innovations Dec 2013 - Minimally Invasive Laparoscopic Adrenalectomy with Endoscope Fusion (pdf) 1.53 MB
- AXIOM Innovations Dec 2012 - Minimally invasive liver resection (pdf) 0.2 MB
- AXIOM Innovations June 2012 - Intuitive and Comfortable Reassimilations in Endourology (pdf) 0.29 MB
- insidehealth May 2012 - 3D in der Urologie (German) (pdf) 0.12 MB
Scientific Talks and Publications
- Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging.
(Kenngott et al., Surg Endosc., Nov 2013) - Surgical navigation in urology: European perspective.
(Rassweiler et al., Curr Opin Urol, Jan 2014) - Laparoscopic radical nephrectomy under near real-time three-dimensional surgical navigation with C-arm cone beam computed tomography.
(Nozaki et al., Surg Innov., Sep 2012) - Efficacy of DynaCT for surgical navigation during complex laparoscopic surgery: an initial experience.
(Nozaki et al., Surg Endosc., 2013)