ArticleSurgical endoscopy2026
Real-time surgical navigation for intraoperative lymph node localization during targeted robot-assisted pelvic and retroperitoneal lymph node dissection.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLocalization of suspected metastatic LNs during targeted robot-assisted lymphadenectomy is challenging due to anatomical variability and surrounding vital structures. Image-guided surgical navigation may improve intraoperative LN localization and completeness of oncologic dissection. The aim of this study is to evaluate the accuracy and usability of surgical navigation for localization of suspected metastatic lymph nodes (LNs) during robot-assisted pelvic and retroperitoneal LN dissection.
methodsPatients with one or more suspected metastatic LNs on preoperative imaging scheduled for robot-assisted pelvic or retroperitoneal LN dissection were prospectively included. A patient-specific three-dimensional (3D) model was automatically registered intraoperatively using electromagnetically tracked ultrasound of the bone surface. Real-time navigation was displayed via the da Vinci® TilePro™ as a 3D model or augmented reality overlay. A tracked pointer or instrument was used for LN localization. Accuracy was defined as the shortest distance between the surgeon-indicated LN and the corresponding 3D model. Usability was assessed using the system usability scale (SUS).
resultsTwenty patients with 40 target LNs were included. One para-aortic LN was inaccessible in a patient with a BMI of 52 kg/m
conclusionsSurgical navigation enabled highly accurate LN localization during robot-assisted pelvic and retroperitoneal LN dissection. The technique is safe, feasible, and supports targeted oncologic surgery and intraoperative decision-making. In the future, wireless tracking systems or simultaneous localization and mapping techniques could allow broader clinical implementation of the navigation technique.
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