Laparoskopik CerrahiRobotic 3D imaging in the OR

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.

Tumor 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

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