iPad-assisted percutaneous nephrolithotomy (PCNL): a matched pair analysis compared to standard PCNL

Rassweiler‐Seyfried, Marie‐Claire; Rassweiler, Jens; Weiß, Christel; Müller, Michael; Meinzer, Hans Peter; Maier-Hein, Lena; Klein, Jan-Thorsten

doi:10.1007/s00345-019-02801-y

Cited by 38 publications

(24 citation statements)

References 22 publications

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“…Only a few papers have reported the clinical application of a 3D visualization model in PCNL, and mainly focused on preoperative planning. 9,15 In this prospective study, we deeply discussed the problem of kidney deviation and evaluated the guiding value of 3D model for intraoperative puncture in a mixed reality environment. Our primary endpoint for the trial is coincidence rate of puncture passage, and the second endpoints include puncture time, stone clearance rate and surgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Although the puncture can be guided by B-ultrasound or X-ray fluoroscopy currently, 5 some new techniques are still urgently needed to make the operation preciser, safer and easier. [6][7][8][9] A 3D visualization model, also known as a 3D reconstruction model, 3D virtual image, or holographic image, is formed by reprocessing patients' original CT/MRI DICOM data with a surface rendering method. Under this model, organs and tissues are manifested in an intuitive, perspective, and interactive way and can offer help for precise surgical planning.…”

Section: Introductionmentioning

confidence: 99%

“…Precise puncture into the targeted renal calyx is crucial but also makes the operation challenging 3,4 . Although the puncture can be guided by B‐ultrasound or X‐ray fluoroscopy currently, 5 some new techniques are still urgently needed to make the operation preciser, safer and easier 6–9 …”

Section: Introductionmentioning

confidence: 99%

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Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

et al. 2022

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Objectives: To establish a three-dimensional visualization model of percutaneous nephrolithotomy, apply it to guiding intraoperative puncture in a mixed reality environment, and evaluate its accuracy and clinical value. Methods: Patients with percutaneous nephrolithotomy indications were prospectively divided into three-dimensional group and control group with a ratio of 1:2. For patients in three-dimensional group, positioning markers were pasted on the skin and enhanced computed tomography scanning was performed in the prone position. Holographic three-dimensional models were made and puncture routes were planned before operation. During the operation, the three-dimensional model was displayed through HoloLens glass and visually registered with the patient's body. Puncture of the target renal calyx was performed under three-dimensional-image guiding and ultrasonic monitoring. Patients in the control group underwent routine percutaneous nephrolithotomy in the prone position under the monitoring of B-ultrasound. Deviation distance of the kidney, puncture time, puncture attempts, channel coincidence rate, stone clearance rate, and postoperative complications were assessed.Results: Twenty-one and 40 patients were enrolled in three-dimensional and control group, respectively. For three-dimensional group, the average deviation between virtual and real kidney was 3.1 AE 2.9 mm. All punctures were performed according to preoperative planning. Compared with the control group, the three-dimensional group had shorter puncture time (8.9 AE 3.3 vs 14.5 AE 6.1 min, P < 0.001), fewer puncture attempts (1.4 AE 0.6 vs 2.2 AE 1.5, P = 0.009), and might also have a better performance in stone clearance rate (90.5% vs 72.5%, P = 0.19) and postoperative complications (P = 0.074). Conclusions: The percutaneous nephrolithotomy three-dimensional model manifested acceptable accuracy and good value for guiding puncture in a mixed reality environment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

et al. 2022

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“…Hier bietet sich inzwischen die Virtuelle Realität mit Ihren unterschiedlichen Na-vigationstechniken an [59,64]. Markerbasiert kann die Nierenanatomie mit dem iPAD dargestellt werden [65,66] und das Dyna-CT ermöglicht quasi in Echtzeit eine dreidimensionale Darstellung des Hohlsystems als Basis einer laser-assistierten Punktion [67]. Am vielversprechendsten scheint hier die Elektromagnetische Navigation der Punktionsnadel über einen mit dem flexiblen Ureteroskop eingebrachten Sensors zu sein.…”

Section: Geschichte Der Endourologieunclassified

50 Jahre Minimal-invasive Chirurgie in der Urologie

et al. 2019

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ZusammenfassungDie Entwicklung der Minimal-invasiven Chirurgie (MIC) in der Urologie umfasst die Teilbereiche transurethrale Techniken, Endourologie und Extrakorporale Stosswellenlithotripsie, Uroradiologie sowie Laparoskopie und Robotische Chirurgie. Basierend auf persönlichen Erfahrungen mit der Entwicklung minimal-invasiver Verfahren seit Ende der 70iger Jahren präsentieren wir eine historische Analyse der Literatur mit dem Ziel, die wesentlichen Meilensteine der Minimal-Invasiven Therapie in der Urologie herauszuarbeiten.Motor der rasanten Entwicklung der MIC in der Urologie war die Einführung der digitalen Videotechnologie, Lasertechnologie, Fortschritte der Elektrochirurgie begleitet von den Glanzleistungen vor allem Deutscher Technologiefirmen mit zunehmender Miniaturisierung des Instrumentariums. Bedeutsam war auch die gute Kooperation zwischen Urologen, Ingenieuren und Radiologen.Die Laparoskopie wird trotz zahlreicher Weiterentwicklungen (3D-Prismentechnolgie, ETHOS-chair) zunehmend von der Robotik ersetzt. Auf Grund der auslaufendenden Patenten von Intuitive Surgical existiert seit diesem Jahr eine Konkurrenzsituation mit neuen Herstellern von Operationsrobotern. Allerdings müssen diese erst belegen, ob sie den hohen Qualitätsstandard der aktuellen Da Vinci-serie bieten können. Robotersysteme für die Endourologie werden zukünftig eine Rolle spielen, wie Avicenna RoboflexR für die flexible Ureteroskopie und AquaBeamR- für die roboter-assistierte Aquaablation der Prostata. Während RoboflexR ähnlich dem Da Vinci-system die Ergonomie des Eingriffes erleichtert, ersetzt die robotergestützte Aquablation erstmals den Operateur.

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“…Fluoroscopy though an indispensable tool for endourologists, is associated with significant radiation exposure [6]. Various modifications have been described to reduce radiation exposure during PCNL [7,8] and overall radiation exposure in patients with urolithiasis [9]. Amongst all the urological procedures, PCNL has the highest dose and time of radiation exposure [6,10].…”

Section: Introductionmentioning

confidence: 99%

Access and Fluoroscopy Time Difference in Patients Undergoing Prone Percutaneous Nephrolithotomy (PCNL) With Ureteric Catheter Placement in Supine Versus Lithotomy Position

Mirani¹,

Ather²,

Kazmi³

et al. 2022

Cureus

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Objective: To compare the operative and fluoroscopy time in two different methods of ureteral stent insertion before prone percutaneous nephrolithotomy (PCNL).Materials and method: Over 12 months, 124 patients with urolithiasis who went through prone PCNL were included in our study. All the patients had kidney stones and were divided into two groups based on the method of ureteral catheter insertion. This was done with the help of flexible or rigid cystoscopy in to group A and group B, respectively. Both groups had an equal number of patients, i.e., 62. The main outcome variables assessed were access time (from intubation to placement of access sheath) and fluoroscopy time during access.Results: The categorical variables (age, gender, site of the stone) between the two groups were comparable. The access time in groups A and B were 48±4.30 and 77±10 minutes, respectively. The fluoroscopy times in groups A and B were 52±14.63 and 116±47.77 seconds, respectively. A statistically significant difference (pvalue < 0.05) was observed for both the access and fluoroscopy time. None of the patients in either of the groups had a misplaced ureteral catheter requiring repositioning.Conclusion: Flexible cystoscope-assisted insertion of ureteral catheter prior to PCNL significantly reduces operative time, fluoroscopy time, and consequently radiation exposure during PCNL.

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iPad-assisted percutaneous nephrolithotomy (PCNL): a matched pair analysis compared to standard PCNL

Cited by 38 publications

References 22 publications

Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

Application of a three‐dimensional visualization model in intraoperative guidance of percutaneous nephrolithotomy

50 Jahre Minimal-invasive Chirurgie in der Urologie

Access and Fluoroscopy Time Difference in Patients Undergoing Prone Percutaneous Nephrolithotomy (PCNL) With Ureteric Catheter Placement in Supine Versus Lithotomy Position

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