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The safety and efficacy of minimally invasive surgery relies on visual information. We aimed to develop an integrated image navigation system (RoboSurgeon System) that combines head-mounted displays (HMDs) with multiple image modalities, and assessed its feasibility in 5 prostate cancer patients who underwent gasless single-port endoscopic radical prostatectomy. A robotically manipulated transrectal ultrasound (TRUS) system was used. In all cases, preoperative magnetic resonance (MR) images and intraoperative real-time images of an endoscope, TRUS, and HMD-mounted camera were integrated and displayed synchronously on each HMD in a four-split screen mode during the entire process. The TRUS helped identify the boundary with the adjacent structures endoscopically in reference to MR images. There were no negative incidents in intraoperative or postoperative courses. Integrated image navigation using HMDs as individualized monitors is feasible in the natural ergonomic position and may be beneficial to identify correct dissection planes. The efficacy of the RoboSurgeon System deserves further evaluation. [ABSTRACT FROM AUTHOR]

We developed a new three-dimensional (3D) head-mounted display (HMD) system (RoboSurgeon system) that combines a high-definition 3D organic electroluminescent HMD with a high-definition 3D endoscope and applies it to minimally invasive surgery. This system presents the surgeon with a higher quality of magnified 3D imagery in front of the eyes, regardless of head position. We report 5 cases of RoboSurgeon gasless laparoendoscopic single-port partial cystectomy, which is carried out as part of our selective bladder-sparing protocol, with a technique utilizing both an intravesical and extravesical approach. While carrying out the surgery, the system provides the surgeon with both excellent 3D imagery of the operative field and clear imagery of the cystoscopy. All procedures were safely completed and there were no complications except for a case of postoperative lymphorrhea. Our experience shows that the 3D HMD system might facilitate maneuverability and safety in various minimally invasive procedures. [ABSTRACT FROM AUTHOR]