First look: laser speckle imaging is a novel method to identify and preserve neurovascular bundle during robotic assisted laparoscopic radical prostatectomy

You have accessJournal of UrologyCME1 Apr 2023MP67-12 FIRST LOOK: LASER SPECKLE IMAGING IS A NOVEL METHOD TO IDENTIFY AND PRESERVE NEUROVASCULAR BUNDLE DURING ROBOTIC ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY Matt Mikula, Jay Bishoff, Louis Kavoussi, Lee Richstone, Nicholas Kavoussi, Manish Vira, Vipul Patel, and Arun Rai Matt MikulaMatt Mikula More articles by this author , Jay BishoffJay Bishoff More articles by this author , Louis KavoussiLouis Kavoussi More articles by this author , Lee RichstoneLee Richstone More articles by this author , Nicholas KavoussiNicholas Kavoussi More articles by this author , Manish ViraManish Vira More articles by this author , Vipul PatelVipul Patel More articles by this author , and Arun RaiArun Rai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preserving neurovascular bundle (NVB) is been previously identified as an important factor in maintaining erectile function and urinary continence after prostatectomy. Current approaches for visualizing blood flow/perfusion in real-time are: suboptimal (lack objectivity), cumbersome (need for dye preparation and injection), and lack cost-effective utility (need for large capital equipment). Laser-Speckle-Contrast-Imaging (LSCI) LSCI displays tissue blood flow via coherent laser light scatter from red blood cells without intravenous dye. Herein, we present our initial multi-center experience and feasibility with utilizing this novel technology to identify NVB during robotic assisted laparoscopic radical prostatectomy (RALP). METHODS: RALP was performed in surgeon’s respective institutions (Global Robotics Institute, FL and Northwell Health, NY) with either multiport (Da Vinci Xi) or single port (Da Vinci SP) robotic equipment. ActivSight is an FDA cleared LSCI-based endoscopic imaging module positioned between any endoscope and camera to visualize real-time perfusion. During RALP, a 10mm laparoscope with the ActivSight module was introduced on-demand through an accessory port at key points throughout the case via assistant. RESULTS: In both antegrade and retrograde nerve dissection, ActivSightTM was able to visualize NVB and demonstrate perfusion through dissection (n =15/15). Surgeons did not express any significant workflow alterations or difficulty with using ActivSight during dissection. CONCLUSIONS: To our knowledge, this is the first clinical experience describing laser speckle imaging in real-time visualization of the critical structures during RALP. LSCI provided in all cases the ability to identify and additional confidence in preserving the NVB even to highly experienced surgeons. While information presented here demonstrates some early potential promise, further research and development will be required to validate utility in the NVB preservation. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e947 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matt Mikula More articles by this author Jay Bishoff More articles by this author Louis Kavoussi More articles by this author Lee Richstone More articles by this author Nicholas Kavoussi More articles by this author Manish Vira More articles by this author Vipul Patel More articles by this author Arun Rai More articles by this author Expand All Advertisement PDF downloadLoading ...