In occasion of the 1st and the 2nd meeting held on the 5th September and the 18th October 2018 many progresses have been made at the Department of Computer Science in the University of Verona (Italy).
A small team of experts of the SARAS Consortium have met in Verona to test Prostate’s phantom and the positioning of the SARAS arms with respect to the phantom and the da Vinci® arms, together with Doctor Umberto Capitanio, Surgeon and Senior Researcher at the Renal cancer Unit of the Urological Research Institute at the IRCCS Ospedale San Raffaele.
1. The external phantom box:
The external phantom box simulates the abdomen and it’s composed by a black box, a rigid cage perforated to allow the insertion of the trocars and one or more layer of skin.
2. The involved organs:
Dr. Capitanio provided clear instructions to the Austrian Center for Medical Innovation and Technology to realize the most realistic phantoms of the rectum, the bladder, ureters, urethra, prostate and pelvis in terms of dimensions, color and consistency. One contribution of the Doctor is in fact related to the materials used to realise phantoms that must have the same stiffness of real organs.
3. The other tissues:
The research center focused on minimally invasive surgical procedures received also clear instructions on how better connect the bladder and the prostate; the quantity of the connective tissue needed and the correct position of ureters and vas deferens. Here we can see the Doctor removing some extra tissue because more pneumoperitoneum is needed in the phantom; the connective tissue should wraps up the bladder and prostate until to half height laterally.
4. The SARAS arms positioning:
During our meeting, we chose to change the approach of prostatectomy, from Posterior approach, carried out in San Raffaele Hospital to Anterior approach, it’s easier for phantom’s development. Trocars has been inserted by the Doctor, but the stiffness of the skin was too hard, so we removed the box of phantom to discuss the position of the da Vinci® arms and then, later, we will study the pneumoperitoneum.
The inclination of 30 degrees will be done outside the phantom and there will be another small inclination of the bone (see Figure below) in order to maximise the operating space. The bone will be raised by the box.
The partners involved:
- ACMIT (Gernot Kronreif)
- OSR (Elettra Oleari, Alice Leporini, Diana Trojaniello, Umberto Capitanio)
- UNIVR (Riccardo Muradore, Francesco Setti, Nicola Piccinelli)
- UNIFE (Marcello Bonfé, Alessio Sozzi)
- UNIMORE (Federica Ferraguti, Marco Minelli)
A special thanks to Alice Leporini for documenting these important phases.