At the HINT.GENT Pulse Session on June 12th, two pioneering presentations showcased how digital technologies are reshaping surgical planning and execution. The talks, led by Prof. dr. Charles Van Praet and Prof. dr. Renaat Coopman, highlighted the integration of 3D perfusion modeling in urology and the development of a centralized 3D platform for multidisciplinary surgical innovation.
Precision in Renal Surgery: The PODRACING Trial
The first presentation focused on the PODRACING trial, a multicentric study evaluating the use of a 3D renal perfusion model to guide selective arterial clamping during robot-assisted partial nephrectomy for renal cell carcinoma. The model, developed at UGent, segments patient-specific anatomy from CT scans and applies a validated perfusion algorithm to simulate surgical outcomes.
Key goals include:
- Complete tumor removal with negative margins.
- Preservation of healthy renal tissue.
- Avoidance of complications.
In 92% of cases, the model accurately predicted perfusion zones, offering surgeons a powerful tool for preoperative planning. The trial, launched in 2024 at UZ Gent, has enrolled 75 of its 235 target patients and is expanding to additional centers. A web-based visualization platform, hosted via Microsoft Azure, supports model access and data entry across institutions.
However, integrating commercial AI platforms for automated model generation (<1 minute per model) raises concerns around GDPR compliance, data sharing, and medical device regulation (MDR). These are being addressed through anonymization, informed consent, and collaboration with data protection officers.
Building the Future: The 3D Platform for Surgical Digitalization
Dr. Renaat Coopman’s presentation introduced a broader vision: a centralized 3D platform to support surgical digitalization across disciplines, including urology, maxillofacial surgery, and plastic surgery. The platform serves as a multidisciplinary hub for innovation, enabling virtual surgical planning, AI-enhanced augmented reality, and medical 3D printing.
A standout example was the “Jaw-in-a-Day” protocol, where virtual planning and custom cutting guides enabled precise resection and reconstruction of a mandibular tumor using a vascularized fibula graft. The process included:
- Preoperative design.
- Guided osteotomies and implant placement.
- Immediate prosthetic loading and intraoperative verification.
To support such workflows, the platform requires robust infrastructure:
- High-performance computing (CPU/GPU).
- Secure data storage and GDPR-compliant sharing.
- MDR-certified 3D printing and sterilization facilities.
The proposed 3D Print LAB at UZ Gent aims to internalize production, ensuring compliance, fostering innovation, and supporting research and education. The lab includes dedicated rooms for digital checks, printing, post-processing, and sterilization, with checkpoints to validate each step.
Challenges and Outlook
Following the two presentations, regulatory and ethical complexities of surgical digitalization were discussed with prof. Griet Verhenneman (METAMEDICA) who provided guidance from an legal perspective. Key challenges defined:
- Defining and protecting sensitive patient data.
- Ensuring software tools meet MDR standards.
- Validating AI-driven processes in clinical trials.
The session concluded with a call for a steering group to guide medical digitalization, bridging academia, clinical practice, and industry. As technologies evolve, platforms like these will be essential to ensure safe, effective, and personalized surgical care.