858 CLINICAL USE OF A PATIENT-SPECIFIC SIMULATOR FOR LAPAROSCOPIC RENAL SURGERY

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy I1 Apr 2012858 CLINICAL USE OF A PATIENT-SPECIFIC SIMULATOR FOR LAPAROSCOPIC RENAL SURGERY Kazuhide Makiyama, Hiroyuki Yamanaka, Daiki Ueno, Yoshinobu Kubota, Kentarou Takanami, Manabu Nagasaka, and Masato Ogata Kazuhide MakiyamaKazuhide Makiyama Yokohama, Japan More articles by this author , Hiroyuki YamanakaHiroyuki Yamanaka Yokohama, Japan More articles by this author , Daiki UenoDaiki Ueno Yokohama, Japan More articles by this author , Yoshinobu KubotaYoshinobu Kubota Yokohama, Japan More articles by this author , Kentarou TakanamiKentarou Takanami Kamakura, Japan More articles by this author , Manabu NagasakaManabu Nagasaka Kamakura, Japan More articles by this author , and Masato OgataMasato Ogata Kamakura, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.951AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Training systems that simulate a surgical process are available on a commercial basis. They are useful for basic training, but do not correspond to the specific conditions of each patient. We, therefore, have developed a unique training system: a patient-specific type simulator for laparoscopic surgery. Using specific data of each individual patient, this system enables surgeons to exercise a “rehearsal” operation in virtual reality conditions. We performed preoperative simulations using this simulator for five patients who underwent renal surgery in Yokohama City University. METHODS Dynamic CT of each patient scheduled to undergo renal surgery was captured into the model data generation system. Each patient's specific volume data for the kidneys and organs around the kidney were extracted and entered into the simulator. In the simulator, the organs of each individual patient were reproduced. Two surgeons performed five preoperative simulations. Procedures included two nephroureterectomies, a pyeloplasty, a partial nephrectomy and a simple nephrectomy. The pyeloplasty was performed via transperitoneal approach and the other operations were via retroperitoneal approach. We evaluated whether anatomies reproduced in the simulator were correct or not compared with real operations and interviewed surgeons to determine whether it was useful or not as a preoperative training. RESULTS We were able to confirm that the anatomies were reproduced almost perfectly in the simulator compared with intraoperative findings. Three minor mistakes were identified. In the left pyeloplasty, a crossing vein (kidney→gonadal vein) was located on the back side of the UPJ in the simulator, but was actually just ventral of the UPJ in the operation. In the right partial nephrectomy, a right gonadal vein was connected to the renal vein in the simulator, but was actually connected to vena cava. In the same case, the simulator could not reproduce the lumber vein, which was able to be observed during the operation. In all five cases, surgeons could perform comfortable preoperative training, and stated their impressions that it was useful to make preoperative images. In particular, it was useful to make adequate preoperative images in the case of retroperitoneoscopic nephroureterectomy in renal pelvis urothelial carcinoma with situs inversus totalis. CONCLUSIONS The patient-specific simulator for laparoscopic renal surgery has been successfully developed. We confirmed that it reproduced organs correctly and surgeons feel it is useful as a preoperative training technique. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e350 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazuhide Makiyama Yokohama, Japan More articles by this author Hiroyuki Yamanaka Yokohama, Japan More articles by this author Daiki Ueno Yokohama, Japan More articles by this author Yoshinobu Kubota Yokohama, Japan More articles by this author Kentarou Takanami Kamakura, Japan More articles by this author Manabu Nagasaka Kamakura, Japan More articles by this author Masato Ogata Kamakura, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...