Percutaneous Nephrolithotomy Using an Individual 3-Dimensionally Printed Surgical Guide

Abstract

Percutaneous nephrolithotomy (PNL) is an endoscopic technique used for treating large stones, multiple stones, and staghorn calculi. Although minimally invasive, complication rate of PNL reaches 25%, and it is partially associated with needle puncture during nephrostomy tract preparation. Continuous improvement of armamentarium and imaging methods and the introduction of three-dimensional (3D) visualizations optimize the procedure; however, the rapid and precise establishment of the nephrostomy tract is still difficult. In the present short communication, we present the PNL procedure assisted by a personalized 3D-printed surgical guide (SG) to ensure fast and precise needle access to the renal collecting system. We also describe the workflow for SG preparation, which consists of CT image acquisition and data segmentation, planning a safe needle insertion path, SG designing, and guide manufacturing. With the growing market of low-cost 3D printers, the presented technique can shorten the PNL procedure time and decrease the complication rate associated with needle puncture in a cost-efficient manner.

Safety of Upper Pole Puncture in Percutaneous Nephrolithotomy with the Guidance of Ultrasonography versus Fluoroscopy: A Comparative Study

“…When gaining access, we attempted to enter as laterally as possible because the pleura is located more inferiorly at the mid-scapular line. In a recent study, PCNL was performed using an individual 3-dimensionally printed surgical guide that can decrease the initial access time and decrease the complication rate [24]. After a deep inhalation, we determined the location of the desired calyx.…”

3D printing and urology: Review of the clinical applications

“…We also attempted to quantitatively measure the time required to process the radiological images. However, unfortunately, only 4 teams have indicated the details on the duration of their image postprocessing step: Golab et al, 2h; Wake et al, 7h; Gershman et al, 8 to 12h [24,25,32]. Sampogna et al have demonstrated that their first models required multiple hours which was reduced to less than an hour with the experience gained [27].…”

“…Школа нефролога Likewise, we divided the CAD software pool into 2 groups, commercial and free, and open-source. Only 10 teams have reported their use of CAD software in their 3D printing workflow [15,[24][25][26][27][28][29][30][31][32]. Fig.…”

3D printing in urology: Is it really promising?

“…The ultimate goal is complete stone clearance with lower complication rates, and with the growing market of low-cost 3D printers, PNL procedure can be shortened and the complication associated with needle puncture can be decreased in a cost-efficient manner. [8,9] The prompt evaluation of urological organs is mandatory in traumas. As Peng et al suggested, the enhanced multi -scan CT permits reliable detection of renal trauma and the associated organ or tissue injuries and provide important clinical value for the diagnosis and classification of trauma or internal organ injures, however 3D technology precisely will give guide the surgical decision making process concerning both blunt and penetrating traumas.…”