A novel abdominal phantom model for laparoscopic and robotic exposure of retroperitoneal structures

Abstract

Phantom evaluation of novel image guided surgery techniques enables low-cost, rapid design iteration prior to (or in place of) studies requiring biological specimens. This work introduces a novel, geometrically-accurate anatomical phantom model of surgical exposure of structures in the upper urinary tract. After segmenting the CT scan of a representative study subject, the kidneys, ureters, and associated vasculature were cast in silicone and loaded with barium to facilitate segmentation of phantom tomography. This deformable silicone model was secured to a rigid replication of the spine and retroperitoneal musculature. An acrylic housing was designed to mimic the abdominal cavity and was filled with wool batting to simulate occluding adipose tissue. Initial evaluation on CT showed good subjective correspondence with clinical tomography, as well as physiologically-relevant 25–30 mm kidney displacement between orientations, with the ability to produce larger displacements as would be expected due to intraoperative manipulation. Stereoendoscopic views of partially occluded structures during simulated dissection with the da Vinci S and Xi Surgical Systems show promise for use in developing and validating image guidance tools for surgical exposure in the abdomen.