Application of holographic image in preoperative planning and assisting puncture of percutaneous nephrolithotripsy
Wang lei1, Wang Gang1, Zhao Zichen1, Liu Kun2, Yang Hongwei2, Na Manli3, Li Xiaojian1, Pan Dongliang1, Li Ningchen1,*, Na Yanqun1
1 Wujieping Urology Center, Peking University Shougang Hospital,Beijing 100000;
2 Beijing Renxin Medical Technology Co., Ltd,Beijing 100041;
3 Department of Medical Imaging, Peking University Shougang Hospital,Beijing 100000
Abstract：Objective: To investigate the feasibility and clinical value of holographic image in preoperative planning and assisting ultrasound-guided puncture of percutaneous nephrolithotripsy （PCNL）. Method: The clinical data of 30 patients with holographic assisted PCNL performed in Peking University Shougang Hospital from May 2020 to February 2022 were analyzed retrospectively. The mean age was （53.6±11.9） years old, and the S.T.O.N.E stone score was 7 （range 5-10）. Enhanced CT scan of urinary system in operation body position was performed within one week before the operation, and posture pads, positioning stickers and respiratory control were used. The original data of CT were obtained, holographic image models were made and the puncture paths were planned for target renal calyces. The preoperative cognitive surgical simulation was performed to estimate the stone removal range, the “simulated ultrasound images” passing through the puncture path were made. During the operation, the patient took the same body position as in CT scan. The surgeon team adopted the mixed reality head mounted display mode or the plane viewer mode, so that the holographic image could be used to assist the surgeon to identify the target renal calyx and the skin puncture point under ultrasound accurately and quickly. Next, the surgeon could perform ultrasound-guided precise puncture according to the preoperative plan. The operation related data and postoperative complications were recorded. Results: All operations on the 30 cases were successfully carried out. The average total operation time and puncture time were （93.3±32.6） min and （8.5±3.6） min, respectively. The number of puncture channels was 1 （1-3）, and the number of puncture attempts was 1 （1-3）. The coincidence rate between the actual puncture channel and the planning was 97.1% （34/35）, and the complete stone removal rate was 93.3% （28/30）. There were 7 cases （23.3%）, 3 cases （10%） and 0 case of Clavien-Dindo complications of grade Ⅰ, Ⅱ and Ⅲ-Ⅴ, respectively. Conclusion: The application of holographic image in preoperative planning and intraoperative assistance of PCNL is feasible. The multimodal mode combined with ultrasound is helpful to establish percutaneous renal channel accurately and avoid serious complications.
汪磊, 王刚, 赵子臣, 刘坤, 杨宏伟, 那曼丽, 李晓建, 潘东亮, 李宁忱, 那彦群. 全息影像在经皮肾镜碎石取石术术前规划和辅助穿刺中的应用[J]. 微创泌尿外科杂志, 2022, 11(3): 209-214.
Wang lei, Wang Gang, Zhao Zichen, Liu Kun, Yang Hongwei, Na Manli, Li Xiaojian, Pan Dongliang, Li Ningchen, Na Yanqun. Application of holographic image in preoperative planning and assisting puncture of percutaneous nephrolithotripsy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(3): 209-214.
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