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Navigierte urologische Chirurgie

Möglichkeiten und Grenzen aktueller Technik

Navigation in urological surgery

Possibilities and limits of current techniques

  • Urologische Forschung
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Zusammenfassung

Der Begriff navigierte Chirurgie beschreibt das Konzept der Echtzeitverarbeitung und Präsentation prä- und intraoperativer Daten unterschiedlicher Quellen mit dem Ziel, dem Operateur intraoperativ eine kognitive Unterstützung zu bieten. Zu den durch ein Navigationssystem verarbeiteten Datenquellen gehören bildgebende Methoden wie dreidimensionaler (3D-)Ultraschall, Magnetresonanztomographie (MRT), Computertomographie (CT) u. a. sowie optische, elektromagnetische oder mechanische Trackingmethoden. Nach der Informationsaufarbeitung werden diese in geeigneter Form dem Operateur präsentiert. Weit verbreitet ist eine Visualisierung mittels „virtual reality“ oder „augmented reality“. Für diverse Fachrichtungen sind unterschiedliche Navigationssysteme im Einsatz. Meist erfolgt ihre Anwendung an rigiden Strukturen (Knochen, Gehirn). Für die Navigation an Weichgeweben besteht die Notwendigkeit einer Bewegungskompensation und einer Deformationsdetektion. Zu diesem Zweck werden in der Urologie bei mehreren Anwendungsbeispielen markerbasierte Trackingverfahren eingesetzt. Häufig sind die Systeme jedoch im Entwicklungsstadium und noch nicht in der klinischen Routine angekommen.

Abstract

Surgical navigation describes the concept of real-time processing and presentation of preoperative and intraoperative data from different sources to intraoperatively provide surgeons with additional cognitive support. Imaging methods such as 3D ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) and data from optical, electromagnetic or mechanical tracking methods are used. The resulting information of the navigation system will be presented by the means of visual methods. Mostly virtual reality or augmented reality visualization is used. There are different guidance systems for various disciplines introduced. Mostly it operates on rigid structures (bone, brain). For soft tissue navigation motion compensation and deformation detection are necessary. Therefore, marker-based tracking methods are used in several urological application examples; however, the systems are often still under development and have not yet arrived in the clinical routine.

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Einhaltung ethischer Richtlinien

Interessenkonflikt: T. Simpfendörfer, G. Hatiboglu, B.A. Hadaschik, E. Wild, L. Maier-Hein, M.-C. Rassweiler, J. Rassweiler, M. Hohenfellner und D. Teber geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Urologische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    T. Simpfendörfer , MSc, G. Hatiboglu, B.A. Hadaschik, M. Hohenfellner & D. Teber

  2. Computer-assistierte Interventionen, DKFZ Heidelberg, Heidelberg, Deutschland

    E. Wild, L. Maier-Hein & M.-C. Rassweiler

  3. Urologische Klinik, SLK-Kliniken, Universität Heidelberg, Heilbronn, Deutschland

    J. Rassweiler

Authors
  1. T. Simpfendörfer , MSc
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  2. G. Hatiboglu
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  3. B.A. Hadaschik
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  4. E. Wild
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  5. L. Maier-Hein
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  6. M.-C. Rassweiler
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  7. J. Rassweiler
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  8. M. Hohenfellner
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  9. D. Teber
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Corresponding author

Correspondence to T. Simpfendörfer , MSc.

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Simpfendörfer, T., Hatiboglu, G., Hadaschik, B. et al. Navigierte urologische Chirurgie. Urologe 54, 709–715 (2015). https://doi.org/10.1007/s00120-014-3709-8

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  • DOI: https://doi.org/10.1007/s00120-014-3709-8

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