DOI: 10.1007/s00259-018-4095-zPages: 49-53

Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation

1. Leiden University Medical Center (LUMC), Interventional Molecular Imaging Laboratory, Department of Radiology

2. Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital


4. Technical University of Munich, Department of Urology

5. University Medical Center Hamburg-Eppendorf, Martini-Clinic

Correspondence to:
Fijs W. B. Leeuwen
Tel: +31-715266029




Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed. Here we present the first in vivo feasibility study of this technology in prostate cancer patients.


Ten patients scheduled for a sentinel node procedure received four injections into the prostate with (indocyanine green-)99mTechnetium-nanocolloid and underwent preoperative imaging (lymphoscintigraphy and SPECT/CT). The DROP-IN probe was inserted via the assistant port, still permitting the insertion and usage of additional laparoscopic tools.


The sentinel nodes were resected using the da Vinci® Si robot under guidance of DROP-IN gamma tracing and fluorescence imaging. The surgeon was able to independently maneuver the DROP-IN probe using the ProGrasp® forceps of the da Vinci® robot and distinguish sentinel nodes from background signal (such as the injection site).


Overall the DROP-IN design proves to be a valuable tool for robot-assisted radioguided surgery approaches.

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  • Accepted: Jul 16, 2018
  • Online: Jul 27, 2018

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