{"title":"高精度三维虚拟解剖彩虹模型有助于机器人辅助肾部分切除术中的手术规划和安全选择性钳夹","authors":"","doi":"10.1016/j.ajur.2023.08.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To highlight the role of hyper accuracy three-dimensional (3D) reconstruction in facilitating surgical planning and guiding selective clamping during robot-assisted partial nephrectomy (RAPN).</div></div><div><h3>Methods</h3><div>A transperitoneal RAPN was performed in a 62-year-old male patient presenting with a 4 cm right anterior interpolar renal mass (R.E.N.A.L nephrometry score 7A). An abnormal vasculature was observed, with a single renal vein and two right renal arteries originating superiorly to the vein and anterior, when dividing in their segmental branches. According to the hyper accuracy 3D (HA3D®) rainbow model (MEDICS Srl, Turin, Italy), one branch belonging to one of the segmental arteries was feeding the tumor. This allowed for an accurate prediction of the area vascularized by each arterial branch. The 3D model was included in the intraoperative console view during the whole procedure, using the TilePro feature. A step-by-step explanation of the procedure is provided in the video attached to the present article.</div></div><div><h3>Results</h3><div>The operative time was 90 min with a warm ischemia time on selective clamping of 13 min. Estimated blood loss was 180 mL. No intraoperative complication was encountered and no drain was placed at the end of the procedure. The patient was discharged on postoperative Day 2, without any early postoperative complications. The final pathology report showed a pathological tumor stage 1 clear cell renal cell carcinoma with negative surgical margins.</div></div><div><h3>Conclusion</h3><div>The present study and the attached video illustrate the value of 3D rainbow model during the planning and execution of a RAPN with selective clamping. It shows how the surgeon can rely on this model to be more efficient by avoiding unnecessary surgical steps, and to safely adopt a “selective” clamping strategy that can translate in minimal functional impact.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"11 4","pages":"Pages 660-665"},"PeriodicalIF":2.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hyper accuracy three-dimensional virtual anatomical rainbow model facilitates surgical planning and safe selective clamping during robot-assisted partial nephrectomy\",\"authors\":\"\",\"doi\":\"10.1016/j.ajur.2023.08.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To highlight the role of hyper accuracy three-dimensional (3D) reconstruction in facilitating surgical planning and guiding selective clamping during robot-assisted partial nephrectomy (RAPN).</div></div><div><h3>Methods</h3><div>A transperitoneal RAPN was performed in a 62-year-old male patient presenting with a 4 cm right anterior interpolar renal mass (R.E.N.A.L nephrometry score 7A). An abnormal vasculature was observed, with a single renal vein and two right renal arteries originating superiorly to the vein and anterior, when dividing in their segmental branches. According to the hyper accuracy 3D (HA3D®) rainbow model (MEDICS Srl, Turin, Italy), one branch belonging to one of the segmental arteries was feeding the tumor. This allowed for an accurate prediction of the area vascularized by each arterial branch. The 3D model was included in the intraoperative console view during the whole procedure, using the TilePro feature. A step-by-step explanation of the procedure is provided in the video attached to the present article.</div></div><div><h3>Results</h3><div>The operative time was 90 min with a warm ischemia time on selective clamping of 13 min. Estimated blood loss was 180 mL. No intraoperative complication was encountered and no drain was placed at the end of the procedure. The patient was discharged on postoperative Day 2, without any early postoperative complications. The final pathology report showed a pathological tumor stage 1 clear cell renal cell carcinoma with negative surgical margins.</div></div><div><h3>Conclusion</h3><div>The present study and the attached video illustrate the value of 3D rainbow model during the planning and execution of a RAPN with selective clamping. It shows how the surgeon can rely on this model to be more efficient by avoiding unnecessary surgical steps, and to safely adopt a “selective” clamping strategy that can translate in minimal functional impact.</div></div>\",\"PeriodicalId\":46599,\"journal\":{\"name\":\"Asian Journal of Urology\",\"volume\":\"11 4\",\"pages\":\"Pages 660-665\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Journal of Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214388223000966\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214388223000966","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Hyper accuracy three-dimensional virtual anatomical rainbow model facilitates surgical planning and safe selective clamping during robot-assisted partial nephrectomy
Objective
To highlight the role of hyper accuracy three-dimensional (3D) reconstruction in facilitating surgical planning and guiding selective clamping during robot-assisted partial nephrectomy (RAPN).
Methods
A transperitoneal RAPN was performed in a 62-year-old male patient presenting with a 4 cm right anterior interpolar renal mass (R.E.N.A.L nephrometry score 7A). An abnormal vasculature was observed, with a single renal vein and two right renal arteries originating superiorly to the vein and anterior, when dividing in their segmental branches. According to the hyper accuracy 3D (HA3D®) rainbow model (MEDICS Srl, Turin, Italy), one branch belonging to one of the segmental arteries was feeding the tumor. This allowed for an accurate prediction of the area vascularized by each arterial branch. The 3D model was included in the intraoperative console view during the whole procedure, using the TilePro feature. A step-by-step explanation of the procedure is provided in the video attached to the present article.
Results
The operative time was 90 min with a warm ischemia time on selective clamping of 13 min. Estimated blood loss was 180 mL. No intraoperative complication was encountered and no drain was placed at the end of the procedure. The patient was discharged on postoperative Day 2, without any early postoperative complications. The final pathology report showed a pathological tumor stage 1 clear cell renal cell carcinoma with negative surgical margins.
Conclusion
The present study and the attached video illustrate the value of 3D rainbow model during the planning and execution of a RAPN with selective clamping. It shows how the surgeon can rely on this model to be more efficient by avoiding unnecessary surgical steps, and to safely adopt a “selective” clamping strategy that can translate in minimal functional impact.
期刊介绍:
Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.