Background:The aims were to describe a software-based reconstruction of the patient-specific kidney cavity intraluminal appearance via a head-mounted device and to estimate its feasibility for training novices.Materia...Background:The aims were to describe a software-based reconstruction of the patient-specific kidney cavity intraluminal appearance via a head-mounted device and to estimate its feasibility for training novices.Materials and methods:In total,15 novices were recruited.Each novice was shown a three-dimensional reconstruction of a patient's computed tomography scan,whose kidney was printed.They then joined the surgeon in the operating room and assisted them in detecting the stone during flexible ureteroscopy on the printed model.Then,each participant did a 7-day virtual reality(VR)study followed by virtual navigation of the printed kidney model and came to the operating room to help the surgeon with ureteroscope navigation.The length of the procedure and the number of attempts to find the targeted calyx were compared.Results:With VR training,the length of the procedure(p=0.0001)and the number of small calyces that were incorrectly identified as containing stones were significantly reduced(p=0.0001).All the novices become highly motivated to improve their endourological skills further.Participants noticed minimal values for nausea and for disorientation.However,oculomotor-related side effects were defined as significant.Five specialists noticed a good similarity between the VR kidney cavity representation and the real picture,strengthening the potential for the novice's education via VR training.Conclusions:Virtual reality simulation allowed for improved spatial orientation within the kidney cavity by the novices and could be a valuable option for future endourological training and curricula.展开更多
Urinary leak is one of the most significant complications after partial nephrectomy.In case of persistent urine leaks,placement of a ureteral stent is effective but not always sufficient.This study included 5 patients...Urinary leak is one of the most significant complications after partial nephrectomy.In case of persistent urine leaks,placement of a ureteral stent is effective but not always sufficient.This study included 5 patients with persistent urinary leak after partial nephrectomy.The patients underwent flexible ureteroscopy wherein we identified the damaged calyx.Subsequently,we performed percutaneous puncture targeting the distal end of the endoscope at this calyx and installed a nephrostomy tube.Then,the endoscope was removed,and the ureter was drained with a stent.Ureteral stenting ensures elimination of urinary leak in most patients after partial nephrectomy.In patients with persistent urinary leak,retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice because it allows for rapid and effective treatment of urinary fistulas.展开更多
文摘Background:The aims were to describe a software-based reconstruction of the patient-specific kidney cavity intraluminal appearance via a head-mounted device and to estimate its feasibility for training novices.Materials and methods:In total,15 novices were recruited.Each novice was shown a three-dimensional reconstruction of a patient's computed tomography scan,whose kidney was printed.They then joined the surgeon in the operating room and assisted them in detecting the stone during flexible ureteroscopy on the printed model.Then,each participant did a 7-day virtual reality(VR)study followed by virtual navigation of the printed kidney model and came to the operating room to help the surgeon with ureteroscope navigation.The length of the procedure and the number of attempts to find the targeted calyx were compared.Results:With VR training,the length of the procedure(p=0.0001)and the number of small calyces that were incorrectly identified as containing stones were significantly reduced(p=0.0001).All the novices become highly motivated to improve their endourological skills further.Participants noticed minimal values for nausea and for disorientation.However,oculomotor-related side effects were defined as significant.Five specialists noticed a good similarity between the VR kidney cavity representation and the real picture,strengthening the potential for the novice's education via VR training.Conclusions:Virtual reality simulation allowed for improved spatial orientation within the kidney cavity by the novices and could be a valuable option for future endourological training and curricula.
文摘Urinary leak is one of the most significant complications after partial nephrectomy.In case of persistent urine leaks,placement of a ureteral stent is effective but not always sufficient.This study included 5 patients with persistent urinary leak after partial nephrectomy.The patients underwent flexible ureteroscopy wherein we identified the damaged calyx.Subsequently,we performed percutaneous puncture targeting the distal end of the endoscope at this calyx and installed a nephrostomy tube.Then,the endoscope was removed,and the ureter was drained with a stent.Ureteral stenting ensures elimination of urinary leak in most patients after partial nephrectomy.In patients with persistent urinary leak,retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice because it allows for rapid and effective treatment of urinary fistulas.