Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed. Here we present the first in vivo feasibility study of this technology in prostate cancer patients.
Ten patients scheduled for a sentinel node procedure received four injections into the prostate with (indocyanine green-)99mTechnetium-nanocolloid and underwent preoperative imaging (lymphoscintigraphy and SPECT/CT). The DROP-IN probe was inserted via the assistant port, still permitting the insertion and usage of additional laparoscopic tools.
The sentinel nodes were resected using the da Vinci® Si robot under guidance of DROP-IN gamma tracing and fluorescence imaging. The surgeon was able to independently maneuver the DROP-IN probe using the ProGrasp® forceps of the da Vinci® robot and distinguish sentinel nodes from background signal (such as the injection site).
Overall the DROP-IN design proves to be a valuable tool for robot-assisted radioguided surgery approaches.
European journal of nuclear medicine and molecular imaging. 2018 Jul 27 [Epub ahead of print]
Philippa Meershoek, Matthias N van Oosterom, Hervé Simon, Laurent Mengus, Tobias Maurer, Pim J van Leeuwen, Esther M K Wit, Henk G van der Poel, Fijs W B van Leeuwen
Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, PO Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands., , Eurorad S.A., 2 rue Ettore Bugatti, 67201, Eckbolsheim, France., Department of Urology, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany., Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands., Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, PO Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. .