Publications by authors named "Pieter DE Backer"

Objective: This systematic review investigates of Augmented Reality (AR) systems used in minimally invasive surgery of deformable organs, focusing on initial registration, dynamic tracking, and visualization. The objective is to acquire a comprehensive understanding of the current knowledge, applications, and challenges associated with current AR-techniques, aiming to leverage these insights for developing a dedicated AR pulmonary Video or Robotic Assisted Thoracic Surgery (VATS/RATS) workflow.

Methods: A systematic search was conducted within Embase, Medline (Ovid) and Web of Science on April 16, 2024, following the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA).

View Article and Find Full Text PDF
Article Synopsis
  • * In healthcare, it can help with things like training surgeons using virtual worlds, planning surgeries with 3D models, and guiding surgeons during operations.
  • * There are exciting possibilities ahead, like better patient care through monitoring and education, but we need to solve issues with data security before diving in fully.
View Article and Find Full Text PDF
Article Synopsis
  • * Robotic surgery is particularly adept at addressing these challenges, as it allows for the simultaneous display of multiple data inputs to assist the surgeon, though real-time processing of occlusions demands significant computational power.
  • * This study introduces a groundbreaking real-time segmentation system tested in three robotic surgeries that enhances safety and usability by accurately identifying non-organic surgical tools, thereby promoting the integration of AR technology in minimally invasive procedures.
View Article and Find Full Text PDF

Generative artificial intelligence is able to collect, extract, digest, and generate information in an understandable way for humans. As the first surgical applications of generative artificial intelligence are applied, this perspective paper aims to provide a comprehensive overview of current applications and future perspectives for the application of generative artificial intelligence in surgery, from preoperative planning to training. Generative artificial intelligence can be used before surgery for planning and decision support by extracting patient information and providing patients with information and simulation regarding the procedure.

View Article and Find Full Text PDF

Objective: Develop a pioneer surgical anonymization algorithm for reliable and accurate real-time removal of out-of-body images validated across various robotic platforms.

Background: The use of surgical video data has become a common practice in enhancing research and training. Video sharing requires complete anonymization, which, in the case of endoscopic surgery, entails the removal of all nonsurgical video frames where the endoscope can record the patient or operating room staff.

View Article and Find Full Text PDF

Background: In partial nephrectomy for highly complex tumors with expected long ischemia time, renal hypothermia can be used to minimize ischemic parenchymal damage.

Objective: To describe our case series, surgical technique, and early outcomes for robot-assisted partial nephrectomy (RAPN) using intra-arterial cold perfusion through arteriotomy.

Design Setting And Participants: A retrospective analysis was conducted of ten patients with renal tumors (PADUA score 9-13) undergoing RAPN between March 2020 and March 2023 with intra-arterial cooling because of expected arterial clamping times longer than 25 min.

View Article and Find Full Text PDF

Objective: In the last years, robotic surgery was introduced in several different settings with good perioperative results. However, its role in the management of adrenal masses is still debated. In order to provide a contribution to this field, we described our step-by-step technique for robotic adrenalectomy (RA) and related modifications according to the type of adrenal mass treated.

View Article and Find Full Text PDF

(1) Background: Surgical phases form the basic building blocks for surgical skill assessment, feedback, and teaching. The phase duration itself and its correlation with clinical parameters at diagnosis have not yet been investigated. Novel commercial platforms provide phase indications but have not been assessed for accuracy yet.

View Article and Find Full Text PDF

This study aims to evaluate the abdominal aortic atherosclerotic plaque index (API)'s predictive role in patients with pre-operatively or post-operatively developed chronic kidney disease (CKD) treated with robot-assisted partial nephrectomy (RAPN) for renal cell carcinoma (RCC). One hundred and eighty-three patients (134 with no pre- and post-operative CKD (no CKD) and 49 with persistent or post-operative CKD development (post-op CKD)) who underwent RAPN between January 2019 and January 2022 were deemed eligible for the analysis. The API was calculated using dedicated software by assessing the ratio between the CT scan atherosclerotic plaque volume and the abdominal aortic volume.

View Article and Find Full Text PDF

Purpose: In the emerging field of robotics, only few studies investigated the transition between different robotic platforms in terms of surgical outcomes. We aimed at assessing surgical outcomes of patients receiving robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN) at a high-volume robotic center during the transition from Si to Xi Da Vinci surgical systems.

Methods: We analyzed data of 1884 patients undergoing RARP (n = 1437, 76%) and RAPN (n = 447, 24%) at OLV hospital (Aalst, Belgium) between 2011 and 2021.

View Article and Find Full Text PDF

The prevalence of renal cell carcinoma (RCC) is increasing due to advanced imaging techniques. Surgical resection is the standard treatment, involving complex radical and partial nephrectomy procedures that demand extensive training and planning. Furthermore, artificial intelligence (AI) can potentially aid the training process in the field of kidney cancer.

View Article and Find Full Text PDF

Background: In the field of robotic surgery, there is a lack of comparative evidence on surgical and functional outcomes of different robotic platforms.

Objective: To assess the outcomes of patients receiving robot-assisted radical prostatectomy (RARP) at a high-volume robotic center with daVinci and HUGO robot-assisted surgery (RAS) surgical systems.

Design, Setting, And Participants: We analyzed the data of 542 patients undergoing RARP ± extended pelvic lymph node dissection at OLV hospital (Aalst, Belgium) between 2021 and 2023.

View Article and Find Full Text PDF

Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1, 2], and it may affect surgical margins rate and functional outcomes [3, 4]. Given the relationship between outcomes and surgical experience [5-7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium).

View Article and Find Full Text PDF
Article Synopsis
  • Several barriers hinder the use of augmented reality (AR) in robotic renal surgery, such as visibility issues with instruments and alignment problems of 3D models.
  • A deep learning algorithm was developed to detect surgical instruments in real-time during procedures like partial nephrectomy and kidney transplantation, using data from over 65,000 labeled instruments.
  • The setup, tested across three hospitals and by four surgeons, improves AR surgery safety but requires further optimization for faster video processing and better handling of organ deformation in clinical settings.
View Article and Find Full Text PDF
Article Synopsis
  • * A study involving 61 patients treated with robot-assisted partial nephrectomy (RAPN) examined various technologies and techniques, including 3D reconstructions and fluorescence imaging, to minimize complications and preserve kidney function.
  • * Results showed a median warm ischemia time of 17 minutes and reported a low complication rate, with only 4.8% having positive surgical margins, indicating satisfactory outcomes for patients undergoing RAPN.
View Article and Find Full Text PDF
Article Synopsis
  • Selective clamping during robot-assisted partial nephrectomy (RAPN) relies on detailed knowledge of a patient's kidney blood flow, which is obtained through imaging technology.
  • The study aimed to validate a custom algorithm that generates 3D models of kidney blood supply to enhance surgical planning for 25 patients treated at Ghent University Hospital between 2020 and 2022.
  • Results showed the algorithm was highly accurate in predicting the ischemic zones, with high ratings from urologists on its performance, though future studies are needed to fully assess its clinical benefits.
View Article and Find Full Text PDF

Clinical data on robot-assisted radical prostatectomy (RARP) performed with the new Hugo robot-assisted surgery (RAS) system are scarce. We described surgical outcomes of 112 consecutive patients who underwent RARP ± extended pelvic lymph-node dissection (ePLND) at OLV Hospital (Aalst, Belgium) between February and November 2022. The median age was 65 yr (interquartile range [IQR] 60-70) and median preoperative prostate-specific antigen (PSA) was 7.

View Article and Find Full Text PDF

Renal cell carcinoma is among major causes of death in patients with Von Hippel-Lindau (VHL) syndrome, and it usually presents with multiple and bilateral lesions that may require multiple renal surgeries. This, in turn, may compromise renal function, resulting in end-stage renal disease. To minimize renal function impairment in these patients, great importance is given to the preservation of functional parenchyma with the use of nephron-sparing techniques.

View Article and Find Full Text PDF

Robot-assisted simple prostatectomy (RASP) has demonstrated better peri-operative outcomes as compared to open simple prostatectomy. However, RASP is still limited by platform availability and cost-effectiveness issues. The new surgical robots increasing competition may spread the robotic approach also in non-oncological fields.

View Article and Find Full Text PDF

Robotic sacropexy (RSC) emerged in the last years as a valid alternative to the laparoscopic technique. However, the robotic approach is still limited by platform availability and concerns about cost-effectiveness. Recently, new robotic platforms joined the market, lowering the costs and offering the possibility to expand the robotic approach.

View Article and Find Full Text PDF

In robot-assisted partial nephrectomy (RAPN) renorrhaphy is used to achieve hemostatic control of the tumoral resection bed, with detrimental impact on renal function. Hemostatic agents are used to achieve rapid and optimal hemostasis. GATT-Patch is a new hemostatic sealant that has already demonstrated promising results.

View Article and Find Full Text PDF