The feasibility of navigation-assisted mapping of bladder tumors during transurethral resection

Introduction: Surgical navigation systems have proven to support surgeons to localize and target anatomical structures. The aim of this study is to investigate the accuracy of reproducing bladder coordinates during transurethral resection using an optical navigation system, as a first step to assess the feasibility of accurate navigation-assisted resection of bladder tumors. Methods: The coordinates of 21 bladder locations in 7 patients were collected using a Medtronic StealthStation Surgical Navigation System with infrared optical tracking. The coordinates of bladder lesions and ureteral orifices were recorded twice, independently, after filling the bladder with an arbitrary fixed volume of 390 mL of saline. Results: The distance, in millimeters, between the coordinates of 2 consecutive measurements of the same bladder location was calculated. Bladder lesions and ureteral orifices could be retrieved with a mean accuracy of 8.2 mm (SD = 6.2; N = 21). Conclusion: Navigation-assisted mapping of the bladder showed to be accurate at constant bladder volumes. Further development of the technology is needed to improve navigation efficiency and to implement augmented reality techniques to facilitate the retrieval of bladder tumors during transurethral resection.