Virtual Reality Surgical Navigation System for Holmium Laser Enucleation of the Prostate

Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 8853)


Holmium Laser Enucleation of the Prostate (HoLEP) is an endoscopic transurethral surgical technique for Benign Prostatic Hyperplasia (BPH) treatment that carries significant benefits compared with the traditional Trans-Urethral Resection of the Prostate (TURP). In HoLEP procedure the portion of the prostate with hyperplasia (adenoma) is cut under endoscopic view. Only a few experts in the world perform HoLEP, since the adenoma borders are not clearly visible in the 2D endoscopic images and consequently the clinicians have difficulties to orientate the laser.

Virtual reality navigators demonstrated their potentialities in many fields of surgery to show hidden structures to direct vision and to restore surgeon’s orientation.

3D trans-rectal ultrasound (US) probe allows acquiring volumetric information containing prostate and adenoma borders, which can be segmented and represented in a virtual environment. To coherently and real-time render the surgical instrument in respect to the patient anatomy, we can employ a tracking system. A crucial aspect of each navigation system regards the virtual scene ergonomics.

We designed and implemented a pilot surgical navigation system to support the surgeons to accomplish the HoLEP, showing them the cutting plane and the outlines of adenoma and the prostatic capsule in respect of the surgical tool.

Under supervision of an expert urologist we studied and tested the optimal way to realize an anthropomorphous US phantom. Furthermore our virtual reality surgical navigator provides various visualization modalities studied on the basis of clinical requirements.

On the basis of our results it will be possible to perform in-vitro trails to evaluate the usability of our solution to precisely enucleate the adenoma along its borders.


HoLEP Virtual Reality Navigation system Benign Prostatic Hyperplasia 


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  1. 1.EndoCAS Center, Department of Translational Research on New Technologies in Medicine and SurgeryUniversity of PisaPisaItaly
  2. 2.Scuola Superiore di Studi Universitari e Perfezionamento S’AnnaPisaItaly
  3. 3.Urology DepartmentCisanello HospitalPisaItaly

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