Increased computational power and improved visualization hardware have generated more opportunities for virtual reality (VR) applications in healthcare. In this study, we test the feasibility of a VR-assisted surgical navigation system for robotic-assisted radical prostatectomy.

The prostate, all magnetic resonance imaging (MRI) visible tumors, and important anatomic structures like the neurovascular bundles, seminal vesicles, bladder, and rectum were contoured on a multiparametric MRI using an in-house segmentation software. Three-dimensional (3-D) VR models were rendered and evaluated in a side room of the operating room. While interacting with the VR platform, a real-time stereo video capture of the in situ prostate was obtained to render a second 3-D model. The MRI-based model was then overlaid on the real-time model by using an automated alignment algorithm.

Ten patients were included in this study. All MRI-based VR models were examined by surgeons immediately prior to surgery and at important steps where visualization of the tumors and their proximity to surrounding anatomic structures were critical. This was mainly during the preparation of the prostatic pedicles, neurovascular plexus, the apex, and bladder neck. All participants found the system useful, especially for tumors with locally aggressive growth patterns. For small and centrally located tumors, the system was not considered beneficial due to lack of integration into the robotic console. A fully integrated system with real-time overlays within the robotic stereo viewer was found to be the ideal scenario.

We deployed a preliminary VR-assisted surgical navigation tool for robotic-assisted radical prostatectomies.

Turkish journal of urology. 2019 Sep 01*** epublish ***

Sherif Mehralivand, Abhishek Kolagunda, Kai Hammerich, Vikram Sabarwal, Stephanie Harmon, Thomas Sanford, Samuel Gold, Graham Hale, Vladimir Valera Romero, Jonathan Bloom, Maria J Merino, Bradford J Wood, Chandra Kambhamettu, Peter L Choyke, Peter A Pinto, Barış Türkbey

Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany., Department of Computer and Information Sciences, University of Delaware, Newark, DE, USA., Bristol Hospital Multi-Specialty Group- Urology, Bristol, CT, USA., George Washington School of Medicine & Health Sciences, Washington, DC, USA., Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, Maryland., Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Center for Interventional Oncology, National Cancer Institute and Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA.