Interactive Virtual Reality Renal Models as an Educational and Preoperative Planning Tool for Laparoscopic Donor Nephrectomy

Xie, Lillian; O’Leary, Mitchell; Jefferson, Francis; Karani, Rajiv; Limfueco, Luke; Parkhomenko, Egor; Sung, John; Ichii, Hirohito; Dafoe, Donald C.; Clayman, Ralph V.; Landman, Jaime

doi:10.1016/j.urology.2020.12.046

Cited by 11 publications

(24 citation statements)

References 9 publications

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“…The majority of studies were conducted in the discipline of neurosurgery (10/24; 42%), 22 , 30 , 36 – 42 with the remaining studies conducted in urology (5/24; 21%), 25 , 28 , 29 , 34 , 35 cardiothoracic surgery (3/24; 13%), 24 , 26 , 32 general surgery (2/24; 8%), 23 , 33 orthopedic surgery (2/24; 8%), 20 , 43 plastic surgery (1/24; 4%), 21 and combined general surgery and urology (1/24; 4%). 27 In total, 264 medical personnel were included across all studies, with the exception of three studies, 20 , 21 , 36 which did not report the number of surgeons who participated.…”

Section: Resultsmentioning

confidence: 99%

“…The median (interquartile range; IQR) operative time was 191 (58) minutes in the iVR group, and 241 (113) minutes in the control group ( P < .001). 34 Patients underwent robotic-assisted partial nephrectomies in two other studies. One found the operative times to be 172.6 ± 48.5 minutes for the iVR group and 173.3 ± 49.6 minutes for the conventional CT or MRI group respectively (P = .70).…”

Section: Resultsmentioning

confidence: 99%

“…Intraoperative blood loss was reported in four controlled trials, with positive findings in favour of iVR in one historical trial, 25 and equivalent results in the three remaining studies. 28 , 29 , 34 The positive historical control trial found that median blood loss during percutaneous nephrolithotomy was 50 mL for iVR planning patients, and 100 mL for conventional preoperative planning patients ( P < .01). 25 In another RCT, the mean estimated blood loss was 124.5 ± 90.5 mL in the iVR group and 145.7 ± 140.4 mL in the control group ( P = .71) for robotic partial nephrectomy.…”

Section: Resultsmentioning

confidence: 99%

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Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review

et al. 2022

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Background. Immersive virtual reality (iVR) facilitates surgical decision-making by enabling surgeons to interact with complex anatomic structures in realistic 3-dimensional environments. With emerging interest in its applications, its effects on patients and providers should be clarified. This systematic review examines the current literature on iVR for patient-specific preoperative planning. Materials and Methods. A literature search was performed on five databases for publications from January 1, 2000 through March 21, 2021. Primary studies on the use of iVR simulators by surgeons at any level of training for patient-specific preoperative planning were eligible. Two reviewers independently screened titles, abstracts, and full texts, extracted data, and assessed quality using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results were qualitatively synthesized, and descriptive statistics were calculated. Results. The systematic search yielded 2,555 studies in total, with 24 full-texts subsequently included for qualitative synthesis, representing 264 medical personnel and 460 patients. Neurosurgery was the most frequently represented discipline (10/24; 42%). Preoperative iVR did not significantly improve patient-specific outcomes of operative time, blood loss, complications, and length of stay, but may decrease fluoroscopy time. In contrast, iVR improved surgeon-specific outcomes of surgical strategy, anatomy visualization, and confidence. Validity, reliability, and feasibility of patient-specific iVR models were assessed. The mean QATSDD score of included studies was 32.9%. Conclusions. Immersive VR improves surgeon experiences of preoperative planning, with minimal evidence for impact on short-term patient outcomes. Future work should focus on high-quality studies investigating long-term patient outcomes, and utility of preoperative iVR for trainees.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review

et al. 2022

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“…15 Further, a 2021 study in the live kidney donor population found interactive VR highly valuable, improving surgeons' understanding of anatomy, decreasing preoperative anxiety, and decreasing operative time. 16 For this case, we chose VR because of its immersive nature and stereoscopic environment. Other modalities of 3D visualization without VR or 3D printing are available, including some used by radiology departments such as Synapse 3D (Fujifilm Corporation) and software-as-service offerings such as Ceevra.…”

Section: Discussionmentioning

confidence: 99%

“… 15 Further, a 2021 study in the live kidney donor population found interactive VR highly valuable, improving surgeons’ understanding of anatomy, decreasing preoperative anxiety, and decreasing operative time. 16 …”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Visualization With Virtual Reality Facilitates Complex Live Donor Renal Transplant

Sonnier

Sawyer

Seal

et al. 2022

TOJ

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Background: Living donor renal transplant involves highly technical operations in both a healthy donor and a recipient with endstage kidney disease. Contrast-enhanced computed tomography angiography (CTA) is used to assess critical donor anatomy, but its interpretation becomes increasingly difficult as renal anatomy becomes more complex. Case Report: A related donor was denied because of prohibitive anatomy seen on the pretransplant evaluation CTA. As the donor was highly motivated to donate, CTA DICOM images were segmented to create a 3-dimensional (3D) model that could be evaluated in an immersive and stereoscopic virtual reality (VR) environment. The donor's anatomy was found to be acceptable, and he was approved. Conclusion:In live donor nephrectomy candidates, 3D reconstruction and VR visualization can be used to facilitate appreciation of complex anatomy.

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Mixed reality applications in urology: Requirements and future potential

Reis

Yılmaz

Rambach

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Mixed reality (MR), the computer-supported augmentation of a real environment with virtual elements, becomes ever more relevant in the medical domain, especially in urology, ranging from education and training over surgeries. We aimed to review existing MR technologies and their applications in urology. Methods A non-systematic review of current literature was performed using the PubMed-Medline database using the medical subject headings (MeSH) term “mixed reality”, combined with one of the following terms: “virtual reality”, “augmented reality”, ‘’urology’’ and “augmented virtuality”. The relevant studies were utilized. Results MR applications such as MR guided systems, immersive VR headsets, AR models, MR-simulated ureteroscopy and smart glasses have enormous potential in education, training and surgical interventions of urology. Medical students, urology residents and inexperienced urologists can gain experience thanks to MR technologies. MR applications are also used in patient education before interventions. Conclusions For surgical support, the achievable accuracy is often not sufficient. The main challenges are the non-rigid nature of the genitourinary organs, intraoperative data acquisition, online and multimodal registration and calibration of devices. However, the progress made in recent years is tremendous in all respects and the gap is constantly shrinking.

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Interactive Virtual Reality Renal Models as an Educational and Preoperative Planning Tool for Laparoscopic Donor Nephrectomy

Cited by 11 publications

References 9 publications

Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review

Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review

Three-Dimensional Visualization With Virtual Reality Facilitates Complex Live Donor Renal Transplant

Mixed reality applications in urology: Requirements and future potential

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