We are pleased that our article outlining a novel image guidance system for robot-assisted partial nephrectomy warranted comment and agree with the sentiment that 3-dimensional imaging in combination with the TilePro (Intuitive Surgical) function of the robot can be used as a surgical global positioning system.It has also been highlighted that image guidance creates the potential for 3D images to assist in preoperative planning.2 This use of patient'Specific virtual reality (VR) offers potential dual benefit. The first, as described, is to allow the surgeon to plan resection preoperatively on preprepared reconstructions, thereby reducing the potential risk to structures such as the collecting system and major arterial branches. Although we agree that this is a worthwhile and feasible exercise, it is important to consider that the current lack of robust tissue deformation modeling methods will reduce the usefulness of this approach. In addition, the process of preparing computerized tomography/ magnetic resonance imaging (CT/MRI) imaging for a VR system involves segmented reconstructions; these are subject to significant interrater variability.This further reduces the accuracy of the 3D VR model when compared with the intra-operative anatomy.
展开▼
