MP09-12 IMMERSIVE VIRTUAL REALITY (IVR) FOR PERCUTANEOUS NEPHROLITHOTOMY: THE MORE YOU KNOW, THE BETTER THE OUTCOME

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP09-12 IMMERSIVE VIRTUAL REALITY (IVR) FOR PERCUTANEOUS NEPHROLITHOTOMY: THE MORE YOU KNOW, THE BETTER THE OUTCOME Andrei D. Cumpanas, Kalon L. Morgan, Antonio R. H. Gorgen, Allen Rojhani, Rohit Bhatt, Candice Minh Tran, Amanda McCormac, Kelvin Vo, Zachary E. Tano, Sohrab N. Ali, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Andrei D. CumpanasAndrei D. Cumpanas More articles by this author , Kalon L. MorganKalon L. Morgan More articles by this author , Antonio R. H. GorgenAntonio R. H. Gorgen More articles by this author , Allen RojhaniAllen Rojhani More articles by this author , Rohit BhattRohit Bhatt More articles by this author , Candice Minh TranCandice Minh Tran More articles by this author , Amanda McCormacAmanda McCormac More articles by this author , Kelvin VoKelvin Vo More articles by this author , Zachary E. TanoZachary E. Tano More articles by this author , Sohrab N. AliSohrab N. Ali More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Roshan M. PatelRoshan M. Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003224.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Understanding the size of a renal stone, its location and relationship with the collecting system is crucial for a successful percutaneous nephrolithotomy (PCNL). Our objective was to study the impact of preoperative immersive virtual reality (iVR) on surgical planning and outcome. METHODS: Between 2019 and 2022, 125 PCNL patients were randomized into either a CT only group (n=75) or an iVR group (n=50). Pre-operatively, using 3D Slicer software, CT scans were rendered into iVR simulations that allowed the surgeon to visualize and manipulate the relevant anatomical landmarks and to simulate the percutaneous approach to the proposed calyx of entry and the renal stone. Surgeon understanding of the case anatomy after viewing the CT scan and after the iVR experience were compared using a Likert scale questionnaire. Postoperative CT scans using 2-3mm cuts were defined as stone free (i.e., no stones), <2 mm remnants, or <4 mm remnants. Postoperative complications were defined using the Clavien classification. RESULTS: There was a significant increase in stone free and <2 mm remnant rate in the iVR group: 19.7% and 17.24%, respectively (Figure 1). There was a trend towards an increased volume of stone ablated per minute of surgery (p=0.07). Of note, 28% of surgeons changed their calyx of choice for PCNL after viewing the iVR model. In the iVR group, there was a 11% lower rate of postoperative complications (Clavien II-III, p=0.013). Surgeons noted that viewing the iVR model enhanced their understanding of the intra-renal anatomy, stone location, stone size, stone shape, orientation of each stone-bearing calyx, and the optimal calyx for renal access (all p<0.01) (Table 1). CONCLUSIONS: Preoperative visualization of an iVR CT generated model improved the urologists’ understanding of the renal anatomy, impacted the surgical plan and was associated with a statistically significant higher stone clearance rate and a lower incidence of Clavien II and III complications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e109 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrei D. Cumpanas More articles by this author Kalon L. Morgan More articles by this author Antonio R. H. Gorgen More articles by this author Allen Rojhani More articles by this author Rohit Bhatt More articles by this author Candice Minh Tran More articles by this author Amanda McCormac More articles by this author Kelvin Vo More articles by this author Zachary E. Tano More articles by this author Sohrab N. Ali More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...