Laparoscopic Radical Nephrectomy Under Near Real-Time Three-Dimensional Surgical Navigation With C-Arm Cone Beam Computed Tomography

Objective. The aim of this study was to demonstrate the advantages of C-arm cone beam computed tomography for imaging guidance of laparoscopic radical nephrectomy (LRN). Methods. Four patients referred to the authors' institution for LRN were included in this study. To visualize the renal vascular anatomy, the Iopamiron 300 contrast agent was injected intravenously. The surgeon could adjust the viewing angle of the images and rotate the reconstructed three-dimensional (3D) image manually by using a mouse-like controller. Using the near real-time 3D navigation images, the surgeon was able to recognize the renal vascular anatomy, and more easily perform the LRN. Results. All procedures were successfully performed with a satisfactory diagnostic yield or therapeutic effect without procedure-related complications. Conclusion. This novel technology has great potential for application in LRN because it enables accurate depiction of the renal vessels and increases surgeon confidence.