图像引导手术导航（IGSN）可以提高手术精度和安全性。微创手术的扩展增加了将这些导航系统集成到机器人辅助手术中的需求。我们的目标是评估机器人辅助前哨淋巴结活检 (SLNB) 中电磁跟踪与 IGSN 的集成。我们进行了一项前瞻性可行性研究来测试 IGSN 在 SLNB 中的使用。总共包括 25 名计划在荷兰癌症研究所接受 SLNB 的患者（2022 年 3 月至 2023 年 3 月）。使用 IGSN 的 SLNB 是使用四臂配置的达芬奇机器人（Intuitive Surgical，桑尼维尔，加利福尼亚州，美国）的标准化技术进行的。可行性确定为通过 IGSN 成功识别的哨兵节点 (SN) 的百分比。成功的 SN 切除被定义为通过导航正确定位 SN 并使用伽马探针进行离体验证。使用系统可用性量表 (SUS) 评估外科医生对机器人辅助 IGSN 工作流程的反馈。根据协议，前 5 名患者用于工作流程优化，后续 20 名患者纳入分析。 IGSN 成功识别了 91% (50/55) 的 SN。没有与导航相关的并发症。外科医生反馈 (SUS) 为 60.9，用户界面和工作流程集成得分最低。机器人辅助手术期间的 IGSN 可行且安全。该技术可以识别和切除预先确定的小盆腔淋巴结。我们对机器人辅助前列腺手术中成像引导导航的可行性进行了研究。我们的结果表明该技术可行、安全且有效。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Image-guided surgical navigation (IGSN) can enhance surgical precision and safety. The expansion of minimally invasive surgery has increased the demand for integration of these navigation systems into robot-assisted surgery. Our objective was to evaluate the integration of electromagnetic tracking with IGSN in robot-assisted sentinel lymph node biopsy (SLNB).We conducted a prospective feasibility study to test the use of IGSN in SLNB. In total, 25 patients scheduled for SLNB at The Netherlands Cancer Institute were included (March 2022 to March 2023). SLNB using IGSN was performed using a standardised technique with a da Vinci robot (Intuitive Surgical, Sunnyvale, CA, USA) in four-arm configuration. Feasibility was determined as the percentage of sentinel nodes (SNs) successfully identified via IGSN. Successful SN resection was defined as SNs correctly localised via navigation and validated ex vivo with a gamma probe. Surgeon feedback on the robot-assisted IGSN workflow was evaluated using the System Usability Scale (SUS).In accordance with the protocol, the first five patients were used for workflow optimisation, and the subsequent 20 patients were included in the analysis. IGSN led to successful identification of 91% (50/55) of the SNs. There were no complications associated with navigation. The surgeon feedback (SUS) was 60.9, with lowest scores reported for the user interface and workflow integration.IGSN during robot-assisted surgery was feasible and safe. The technique allowed identification and removal of predefined small pelvic lymph nodes.We carried out a study on the feasibility of imaging-guided navigation in robot-assisted prostate surgery. Our results show that this technique is feasible, safe, and effective.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.