MRI-guided laparoscopic and robotic surgery for malignancies.

Endoscopic surgery has some clear benefits, but it also has some disadvantages in reducing surgeons' normal dexterity and limiting their ability to deal with difficult situations. Computer-aided surgery has been proposed to overcome some of the drawbacks of traditional minimally invasive surgery. The proposed systems make possible a secure, precise procedure with no limitations on the operator's freedom of movement. Image-guided surgery is a new technical tool in surgical oncology. Interventional magnetic resonance imaging (MRI) has entered a new stage in which computer-based techniques play an expanding role in planning, monitoring, and controlling procedures. MRI-guided surgery not only represents a technical challenge but is a transformation from conventional hand-eye coordination to interactive navigational operations. We have recently developed an MRI-guided robot-assisted interventional surgical system as well as an MRI-compatible endoscope. They allow the performance of precise image-guided interventional therapy and endoscopic surgery. MRI-guided laparoscopic surgery is now feasible for malignancies and will play an important part in the development of minimally invasive therapy.