Mp56-01 a Multi-Institutional, Prospective Comparative Study Evaluating the Clinical Utility of Iris, an Anatomical Modeling Software for Preoperative Surgical Planning and Intra-Operative Navigation During Robot Assisted Partial Nephrectomy

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP56)1 May 2024MP56-01 A MULTI-INSTITUTIONAL, PROSPECTIVE COMPARATIVE STUDY EVALUATING THE CLINICAL UTILITY OF IRIS, AN ANATOMICAL MODELING SOFTWARE FOR PREOPERATIVE SURGICAL PLANNING AND INTRA-OPERATIVE NAVIGATION DURING ROBOT ASSISTED PARTIAL NEPHRECTOMY Ahmed Ghazi, Ravi Munver, Thomas Osinski, Hani Rashid, and Michael Stifelman Ahmed GhaziAhmed Ghazi , Ravi MunverRavi Munver , Thomas OsinskiThomas Osinski , Hani RashidHani Rashid , and Michael StifelmanMichael Stifelman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008940.44711.d4.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our objective was to evaluate the clinical utility and impact of IRIS in comparison to standard CT scan alone for preoperative surgical planning and intraoperative navigation during Robot Assisted Partial Nephrectomy (RAPN). METHODS: 122 patients from two academic institutions scheduled for RAPN underwent preoperative surgical planning and intraoperative navigation using either CT scans (59) or IRIS+CT scans (63). A 5-point Likert-type scale evaluated the impact of each modality on anatomy interpretation, confidence performing a RAPN and procedure efficiency was evaluated for every case. Clinical data was compared for 90 days post-surgery. RESULTS: No statistical difference was found between both groups demographic and tumor data (Figure 1). Mean procedure time (143.5 vs 163.2 min) and mean blood loss (139.2 vs 128.1 cc) were comparable. Mean warm ischemia time (17.4 vs 17.9 min) was almost identical although a greater number of off-clamp (11.3% vs 7.6%) and selective ischemia i.e., 2ry and 3ry branches (35.9% vs 3.8%) were performed with IRIS. No statistical difference was seen in postoperative, 30 and 90-day eGFR, creatinine, and HCT. During intraoperative navigation, surgeons rated (³ 4) that all IRIS cases achieved good spatial sensation of the anatomy vs CT arms cases (100% vs 69.5%). This was most enhanced in patients with high nephrometry score (18 CT vs 20 IRIS), where a 50-80% increase for anatomical interpretation of various critical structures was reported using IRIS. Surgeons preoperatively reviewing IRIS models also reported higher confidence in performing off or selective ischemia vs global ischemia which translated to a higher degree of execution in IRIS arm (49.2%) vs the CT arm (8.47%) (Figure 1). Intraoperatively surgeons reported (³ 4) IRIS improved procedure efficiency in 87.3% of cases vs 18.6% in the CT arm, mainly attributed to ease in interpreting anatomy in the IRIS arm (96.8% vs 22%). CONCLUSIONS: IRIS improved self-reported confidence, efficiency, and complex anatomical interpretation particularly during complex RAPN cases with increased implementation of non-global ischemia approaches despite minimal difference in clinical outcomes. Download PPT Source of Funding: Intuitive © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e925 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ahmed Ghazi More articles by this author Ravi Munver More articles by this author Thomas Osinski More articles by this author Hani Rashid More articles by this author Michael Stifelman More articles by this author Expand All Advertisement PDF downloadLoading ...