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

IF 2.4 3区 医学 Q2 UROLOGY & NEPHROLOGY
{"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}
引用次数: 0

摘要

方法 对一名 62 岁的男性患者进行了经腹腔镜肾部分切除术,患者患有 4 厘米右肾前极间肿块(R.E.N.A.L 肾测量评分 7A)。观察到血管异常,一条肾静脉和两条右肾动脉在分段分支时起源于静脉上方和前方。根据超精确三维(HA3D®)彩虹模型(MEDICS Srl,意大利都灵),属于其中一条节段动脉的分支正在为肿瘤供血。这样就能准确预测每条动脉分支的血管区域。在整个手术过程中,三维模型通过 TilePro 功能显示在术中控制台视图中。手术时间为 90 分钟,选择性钳夹的热缺血时间为 13 分钟。估计失血量为 180 毫升。术中未出现并发症,术后也未放置引流管。患者于术后第 2 天出院,术后早期未出现任何并发症。最终病理报告显示,肿瘤病理分期为 1 期透明细胞肾细胞癌,手术切缘阴性。它展示了外科医生如何依靠该模型避免不必要的手术步骤,从而提高效率,并安全地采用 "选择性 "夹闭策略,将功能影响降至最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Asian Journal of Urology
Asian Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
4.00
自引率
3.80%
发文量
100
审稿时长
4 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信