Objective: To evaluate the application of Mixed Reality technology in the planning of ultrasound-guided percutaneous nephrolithotomy (PCNL) for special types of complex upper urinary stones.
Methods: Clinical data of 15 patients with complex upper urinary stones undergoing ultrasound-guided PCNL were analyzed which included pelvic ectopic kidney, horseshoe kidney, spinal deformity, and transplant kidney. Based on preoperative computed tomography urography (CTU) data, digital 3-dimensional reconstruction is performed, and AI mixed reality is used to project 3-dimensional images in real space. This facilitates preoperative design and planning. The consistency rate of target calyx and channel numbers, stone-free rate, total operative time, percutaneous renal access establish time, decrease in hemoglobin level, surgical complications, and postoperative hospital stay are analyzed.
Results: All patients underwent preoperative planning using mixed reality and successfully completed PCNL. Based on the preoperative planning, we utilized S-PCNL alone or combined with Needle-perc or antegrade/retrograde flexible ureteroscopic surgery. The consistency rate between preoperative planning and intraoperative completion was 87.6%. The stone-free rate was 80%. The average time for establishing the main tract was 2.3 ± 0.3 minutes, and the average total operative time was 61.5 ± 12.2 minutes. The mean decrease in hemoglobin level was 9.6 ± 1.2g/L, and the average postoperative hospital stay was 4.6 ± 0.5 days. There were no occurrences of Clavien-Dindo grade≥II complications.
Conclusion: Preoperative quantification and analysis of imaging data through mixed reality enable 3-dimensional visualization and facilitate surgical plans, and effectively avoid the risks of surrounding organ injury in these special urinary stones cases, make complex surgeries smoother and more controllable.
Copyright © 2024. Published by Elsevier Inc.