The first two artificial intelligence-led oncological surgeries on the kidney and prostate, in world premiere for the use of augmented reality, will be performed today and tomorrow at the IRCCS in Candiolo.
The surgeon will be able to look at the target organ on the camera and at the same time have in front of the eyes in 3D and automatically the virtual models reconstructed by CT and magnetic resonance.
Thanks to augmented reality applied to 3D, it will be possible, for the first time, to 'merge' real and virtual images during the intervention.
In this way, the surgeon will be able to see inside and behind the tumor, as happens with Google glasses.
This allows for precision, minimally invasive and personalized cancer surgery treatment.
The new approach, whose preliminary results were recently published in the European Urology journal, was developed by a team made up of urologists led by Francesco Porpiglia, Full Professor of Urology at the IRCCS Candiolo-San Luigi Hospital of the University of Turin, and biomedical engineers of the Polytechnic of Turin.
With this technique, the surgeon's hand is guided by 3D images of the organs to be operated on and the neoplasms from which they are affected, which can be superimposed on the real organs on the operating field, to allow you to see the inside of the organ affected by the tumor well beyond beyond what he could see with the naked eye, even with the help of the intraoperative camera.
Starting from the radiological images of CT or magnetic resonances, explains Porpiglia, "it is possible to obtain three-dimensional reconstructions of the organ and of the tumor mass. These models have proved to be very useful in the planning phase of the intervention as they provide the surgeon with a spatial vision of the tumor. organ and disease difficult to reach with the naked eye. Today there is an important news that will revolutionize the treatment of cancer ".
The innovative application of augmented reality is made available by specific software: the images of the 3D model present on a digital support are 'combined' (integrated) and synchronized with the intraoperative images, provided by the robotic camera.
This allows the virtual organ to be superimposed on the part to be operated on, allowing the surgeon to see the inside of the tumor in three dimensions in real time and optimizing the coordination between the eye and the hand of the operator who no longer has to look at a monitor outside to see digital images.
"Thanks to the use of 3D models applied to 'augmented reality' - explains Porpiglia - the surgeon can see with millimeter accuracy the point where the neoplasm is located and analyze in detail its relations with the surrounding organs, removing the tumor mass. with unparalleled precision.
Prostate cancer is never identifiable with the naked eye during surgery.
In this context - he adds - augmented reality guides the surgeon in identifying where he is in real time, thus modulating the extent of the surgical removal point by point, so as to preserve as much as possible the nervous structures responsible for the erection and guarantee to the patient sexual potency and urinary continence ".
This technology, he points out, "has also proved very useful in kidney surgery to identify kidney tumors hidden inside the organ and not visible on its surface and its relationship with surrounding structures such as blood vessels".
At the moment, it is not possible to treat all patients or all types of cancer with this approach, but "the progress of recent years - the expert notes - gives us hope and now we certainly have an extra weapon against disease".