Pd22-07 Effect of 3-Dimensional, Virtual Reality Models for Surgical Planning of Robotic Prostatectomy on Trifecta Outcomes: A Randomized Clinical Trial

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (PD22)1 May 2024PD22-07 EFFECT OF 3-DIMENSIONAL, VIRTUAL REALITY MODELS FOR SURGICAL PLANNING OF ROBOTIC PROSTATECTOMY ON TRIFECTA OUTCOMES: A RANDOMIZED CLINICAL TRIAL Joseph Shirk, Robert Reiter, Eric Wallen, Raymond Pak, Thomas Ahlering, Ketan Badani, and James Porter Joseph ShirkJoseph Shirk , Robert ReiterRobert Reiter , Eric WallenEric Wallen , Raymond PakRaymond Pak , Thomas AhleringThomas Ahlering , Ketan BadaniKetan Badani , and James PorterJames Porter View All Author Informationhttps://doi.org/10.1097/01.JU.0001009504.18450.e0.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Planning robotic-assisted laparoscopic radical prostatectomy (RALP) requires surgeons to review two-dimensional Magnetic Resonance Imaging (MRI) images and pathology results to understand three-dimensional (3D) anatomy. We examined the use of virtual 3D models for planning RALP to determine the effect on the trifecta of cancer control, continence, and erectile function. METHODS: Patients undergoing RALP performed by fifteen surgeons at six hospitals were enrolled in a randomized, single-blind clinical trial. Patients were assigned either to a control group undergoing preoperative planning with MRI, or to an intervention group where MRI was supplemented with a 3D model showing anatomic structures, mass(es), and biopsy cores. The model was viewed on the surgeon's mobile phone, in virtual reality using a headset, or on the surgical console using Tile Pro. Postoperative trifecta outcomes and other secondary outcomes were then examined. RESULTS: Ninety-two patients were analyzed with no significant difference in preoperative disease characteristics (Table 1). At the initial patient assessment post-surgery (3 months), there were trends towards lower positive margins, better sexual function and better urinary continence in the intervention group (Table 2). Detectable PSA (>0.1) was significantly lower in the intervention group (31% vs 9%, p=0.035). At 18 months, detectable PSA was significantly lower in the intervention group (18% vs 0%, p=0.012), and there was a significant improvement in erectile function (mean SHIM score 9.8 vs 16.8, p=0.0024) with no change in continence. There were significantly less instances of radiation therapy and/or hormone therapy in the intervention group (32% vs 3%, p=0.002). Surgeons reported changing their operative plan 32% of the time when using the 3D model. CONCLUSIONS: Use of a virtual 3D model when performing RALP improves oncologic and functional outcomes. Source of Funding: Urology Care Foundation Research Scholar Award (Shirk) © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e463 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Joseph Shirk More articles by this author Robert Reiter More articles by this author Eric Wallen More articles by this author Raymond Pak More articles by this author Thomas Ahlering More articles by this author Ketan Badani More articles by this author James Porter More articles by this author Expand All Advertisement PDF downloadLoading ...