MP10-09 USEFULNESS OF RESECTION PROCESS MAP IN RAPN FOR ENDOPHYTIC RENAL TUMORS AND DEVELOPMENT OF VIRTUAL REALITY SIMULATION

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-09 USEFULNESS OF RESECTION PROCESS MAP IN RAPN FOR ENDOPHYTIC RENAL TUMORS AND DEVELOPMENT OF VIRTUAL REALITY SIMULATION Atsushi Okada, Kazuya Ohashi, Kazumi Taguchi, Toshiki Etani, Shoichiro Iwatsuki, Shuzo Hamamoto, Taku Naiki, Ryosuke Ando, Noriyasu Kawai, Keiichi Tozawa, and Takahiro Yasui Atsushi OkadaAtsushi Okada More articles by this author , Kazuya OhashiKazuya Ohashi More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Toshiki EtaniToshiki Etani More articles by this author , Shoichiro IwatsukiShoichiro Iwatsuki More articles by this author , Shuzo HamamotoShuzo Hamamoto More articles by this author , Taku NaikiTaku Naiki More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Noriyasu KawaiNoriyasu Kawai More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , and Takahiro YasuiTakahiro Yasui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted partial nephrectomy (RAPN) for endophytic renal tumors is positioned as a highly difficult procedure, and it is important to perform accurate tumor resection, preserve renal function, and suppress perioperative complications. In this study, we performed a virtual excision simulation Resection Process Map (RPM) on preoperative 3DCT, verified its usefulness, and developed a VR simulation that developed the technology. METHODS: We retrospectively analyzed 100 RAPN cases conducted at our university from November 2012 to May 2020. The medical imaging workstation Ziostation® 2 was used to construct the RPM. From that image, we were able to grasp the arrangement and shape of the vessels and collecting system exposed on the resected surface by deleting the "tumor part with a 5 mm-thick renal parenchymal resection margin" on 3D-CT. The patient background, tumor properties, surgical information, and postoperative results of the endophytic RPM+ (13 patients in group A), the endophytic RPM- (23 patients in group B), and the exophytic group (64 patients in group C) were analyzed. Applying this technology, RPM data was output as an STL files, which is three-dimensional polygon data for each organ, and observation with immersive VR goggles was made possible using the medical VR application Holoeyes® XR. RESULTS: The warm ischemic times in each group were 20.4 minutes, 23.6 minutes, and 22.0 minutes, and group A was 3 minutes and 1 minute or shorter than groups B and C, respectively, but the difference was not significant. The blood loss in each group was 86.6 mL, 98.2 mL, and 111.7 mL, respectively, and which was the smallest in group A, but there was no significant difference between the groups. The surgical margin was positive in one case of the group C, and the postoperative Cre increase was the smallest at 0.03 mg/dL in group A. Grade III or higher complications were found in 4.7% of groups C only. Furthermore, the VR simulation was able to reproduce the excision area equivalent to the robotic surgical field of view for a completely endophytic renal tumor, and by performing the suture simulation, we were able to complete a safe operation. CONCLUSIONS: RPM simulations for RAPN of endophytic renal tumors and VR simulations applying the technology may be useful for achieving smooth and safe surgery. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e171-e172 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Atsushi Okada More articles by this author Kazuya Ohashi More articles by this author Kazumi Taguchi More articles by this author Toshiki Etani More articles by this author Shoichiro Iwatsuki More articles by this author Shuzo Hamamoto More articles by this author Taku Naiki More articles by this author Ryosuke Ando More articles by this author Noriyasu Kawai More articles by this author Keiichi Tozawa More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement Loading ...