Electromagnetic-guided puncture: a tool or a tale?

Abstract

Purpose of reviewThe puncture technique and site of the puncture can impact the clinical outcome and the development of postoperative adverse events following percutaneous nephrolithotomy (PCNL). The aim of the current review was to discuss the available puncture guidance approaches and outline the potential role of the recently introduced electromagnetic-guided method. Recent findingsThe puncture and PCNL tract establishment is usually performed using fluoroscopic or ultrasound guidance or a combination of two approaches. Electromagnetic-guided puncture is one of the most recent advancements of technology. The puncture navigation to the renal collecting system is available after placing a special wire with an electromagnetic tracking sensor into the desired calyx through the flexible ureterorenoscope. The available experimental and clinical studies have shown a high first puncture rate, decreased median time for obtaining a puncture, and shorter learning curves for beginners. SummaryFluoroscopic and ultrasound guidance are the main approaches used by urologists. However, these modalities require a steep learning curve, approximately 60 cases for reaching competency. The initial data on electromagnetic navigation have shown the feasibility and potential promising outcomes of this novel approach. New studies are required to investigate its potential implementation opportunities in the daily practice of urologists.

Application value of surgical navigation system based on deep learning and mixed reality for guiding puncture in percutaneous nephrolithotomy： a retrospective study

“…Electromagnetic guided puncture has a high success rate and a short learning curve for beginners (14). To simplify and enhance puncture success, especially for novices, we attempted to perform percutaneous puncture with a navigation system based on deep learning and mixed reality.…”

“…In a retrospective study, Francesco et al reported that three-dimensional mixed reality hologram guidance for percutaneous puncture was safe, that the procedure was highly effective in clinical practice, and that it was associated with a low intraoperative radiation exposure (11). New imaging techniques, such as three-dimensional printing, visual needles, and electromagnetic navigation system, aim to simplify percutaneous puncture and reduce complications (12,13,14). In our study, the navigation system based on deep learning and mixed reality, which could achieve real-time navigation, was applied for the treatment of kidney stones during percutaneous nephrolithotomy.…”

“…Currently, surgeons primarily perform percutaneous punctures under uoroscopy and ultrasound guidance. However, mastering these techniques requires a lengthy learning curve, typically involving approximately 60 surgeries (4). Emerging puncture positioning technologies, such as iPadassisted navigation, electromagnetic navigation and laser positioning navigation, attempt to simplify this step and reduce complications (5.6).…”

Advances in percutaneous renal puncture: a comprehensive review of the literature

“…Concerning urology, EMN guidance is utilized as a new method for the percutaneous renal puncture. After the selection of the most convenient calyx, a special wire equipped with an electromagnetic tracking sensor is placed via a retrograde flexible ureteroscope [27 ▪ ]. The puncture can be performed under real-time imaging of the orientation and the position of both the needle and the sensor.…”