Understanding Of Renal Anatomy Research Articles

The prevalence of accessory renal arteries in sudanese population in Khartoum State: a cross-sectional CT study from 2017 to 2020

BackgroundRenal artery variations are clinically significant due to their implications for surgical procedures and renal function. However, data on these variations in Sudanese populations are limited. This study aimed to determine the prevalence and characteristics of renal artery variations in a Sudanese population.MethodsA cross-sectional retrospective study was conducted in Khartoum state from October 2017 to October 2020. A total of 400 Sudanese participants who underwent abdominal CT scans were included. Data on demographic characteristics, kidney measurements, and renal vasculature were collected and analyzed using descriptive statistics and inferential tests.ResultsThe mean age of participants was 46.7 ± 18 years, with a nearly equal gender distribution. Overall, renal artery variations were present in 11% of participants, with accessory renal arteries observed in 6% of the study population. Among those with accessory vessels, 50% were on the right side, 29.2% on the left, and 20.8% bilateral, distributed across hilar 29.2%, lower polar 29.2%, and upper polar 41.7% regions. No significant associations were found between accessory renal arteries and age or gender (p-value > 0.05). However, participants with accessory renal arteries exhibited significantly narrower width 5.0 ± 1.4 than those with no with accessory renal arteries 5.8 ± 1.1 (p-value 0.002) Early dividing renal arteries were found in 5% of participants, with nearly half being bilateral. No significant associations were found between the presence of early dividing renal arteries and demographic or renal measurements (p-value > 0.05).ConclusionThis study provides valuable insights into the prevalence and characteristics of renal artery variations in a Sudanese population. The findings contribute to our understanding of renal anatomy in this demographic and can inform clinical practice and surgical planning, particularly in renal transplantation and other renal procedures.

Interactive Virtual Reality Renal Models as an Educational and Preoperative Planning Tool for Laparoscopic Donor Nephrectomy

To evaluate the efficacy of interactive virtual reality (iVR) in providing a three-dimensional (3D) experience with the donor's anatomy for surgeons and patients, we present a retrospective, case-controlled study assessing the impact of iVR renal models prior to LDN on both surgical outcomes and patients' understanding of the procedure. Twenty patients undergoing LDN were prospectively recruited; their contrast-enhanced CT scans were transformed into iVR models. An iVR platform allowed the surgeons to rotate and deconstruct the renal anatomy; patients could also view their anatomy as the procedure was explained to them. Questionnaires assessed surgeons' understanding of renal anatomy after CT alone and after CT+iVR. Surgeons also commented on whether iVR impacted their preoperative plan. Patients assessed their anatomical understanding and anxiety level before and after iVR. Surgical outcomes for the iVR cohort were compared to a retrospectively matched, non-iVR cohort of LDN patients. Surgeons altered their preoperative plan in 18 of 20 LDNs after viewing iVR models. Patients reported better understanding of their anatomy (5/5) and noted decreased preoperative anxiety (5/5) after viewing iVR. When compared to the non-iVR group, the iVR group had a 25% reduction in median operative time (P < .001). In terms of surgical outcomes, patients in the iVR group had a 40% lower median relative change in postoperative creatinine (P < .001). Preoperative viewing of iVR models altered the operative approach, decreased the operative time, and improved donor patient outcomes. iVR models also reduced patients' preoperative anxiety.

PD23-05 INTERACTIVE VIRTUAL REALITY (iVR) AS AN EDUCATIONAL AND PREOPERATIVE PLANNING TOOL FOR LIVING DONOR NEPHRECTOMIES: A CASE-CONTROLLED STUDY

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (PD23)1 Apr 2020PD23-05 INTERACTIVE VIRTUAL REALITY (iVR) AS AN EDUCATIONAL AND PREOPERATIVE PLANNING TOOL FOR LIVING DONOR NEPHRECTOMIES: A CASE-CONTROLLED STUDY Lillian Xie*, Francis Jefferson, Rajiv Karani, Luke Limfueco, Egor Parkhomenko, Mitchell O'Leary, Shoaib Safiullah, John Sung, Roshan Patel, Hirohito Ichii, Donald Dafoe, and Jaime Landman Lillian Xie*Lillian Xie* More articles by this author , Francis JeffersonFrancis Jefferson More articles by this author , Rajiv KaraniRajiv Karani More articles by this author , Luke LimfuecoLuke Limfueco More articles by this author , Egor ParkhomenkoEgor Parkhomenko More articles by this author , Mitchell O'LearyMitchell O'Leary More articles by this author , Shoaib SafiullahShoaib Safiullah More articles by this author , John SungJohn Sung More articles by this author , Roshan PatelRoshan Patel More articles by this author , Hirohito IchiiHirohito Ichii More articles by this author , Donald DafoeDonald Dafoe More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000873.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Computed tomography (CT) requires surgeons to translate more than 2000 images into a mental understanding of the renal anatomy prior to laparoscopic donor nephrectomy (LDN). In contrast, interactive virtual reality (iVR) provides a three-dimensional (3D) “hands-on” experience with the donor’s renal anatomy. Herein, we present a retrospective, case-controlled study to determine if iVR renal models viewed prior to LDN positively impacted surgery. METHODS: Twenty patients undergoing LDN were prospectively recruited. Their CT images were transformed into 3D models and uploaded to an iVR platform. The iVR platform allowed participants to rotate and deconstruct the renal anatomy utilizing a headset and hand-held devices. Surgeons answered questionnaires that assessed their understanding of renal anatomy after viewing CT alone and then after viewing CT+iVR. Patients assessed their anatomical understanding and anxiety level before and after iVR. Surgical outcomes for the iVR cohort included operative time, estimated blood loss, and postoperative complications; these data were compared to a retrospectively-matched, non-iVR cohort of LDN patients based on age, gender, BMI, ASA score, and surgeon from 2013 to 2018. RESULTS: Surgeons altered their surgical plans in 18 out of 20 LDNs (90%) after viewing iVR models due to a significant improvement in understanding of the vascular anatomy (p < 0.001); they also noted increased confidence in the final surgical plan (p < 0.001) (Table 1). Postoperatively, surgeons reported that iVR correlated better with patient anatomy than did CT alone (p < 0.001). Patients reported a better understanding of their anatomy (4.9/5) and decreased anxiety about their surgery (4.5/5) after viewing iVR. When compared to a non-iVR retrospective cohort, the iVR cohort had a mean 24% reduction in operative time (190 ± 57 min vs. 252 ± 67 min, p < 0.001). CONCLUSIONS: Preoperative viewing of CT-derived iVR models altered the operative approach, decreased operative time, and improved the surgeon’s confidence and understanding of the renal anatomy. As a patient education tool, viewing the iVR model reduced patients’ preoperative anxiety. Source of Funding: n/a © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e465-e466 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lillian Xie* More articles by this author Francis Jefferson More articles by this author Rajiv Karani More articles by this author Luke Limfueco More articles by this author Egor Parkhomenko More articles by this author Mitchell O'Leary More articles by this author Shoaib Safiullah More articles by this author John Sung More articles by this author Roshan Patel More articles by this author Hirohito Ichii More articles by this author Donald Dafoe More articles by this author Jaime Landman More articles by this author Expand All Advertisement PDF downloadLoading ...

A systematic review of clinical value of three-dimensional printing in renal disease.

The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%. The other three studies reported that the use of 3D printed models significantly enhanced medical students and specialists' ability to identify anatomical structures when compared to two-dimensional (2D) images alone; and significantly shortened intraoperative ultrasound duration compared to without use of 3D printed models. Seven studies provided qualitative assessments of the usefulness of 3D printed kidney models with findings showing that 3D printed models improved patient's understanding of renal anatomy and pathology; improved medical trainees' understanding of renal malignant tumours when compared to viewing medical images alone; and assisted surgical planning and simulation of renal surgical procedures with significant reductions of intraoperative complications. The cost and time associated with 3D printed kidney model production was reported in 10 studies, with costs ranging from USD$100 to USD$1,000, and duration of 3D printing production up to 31 h. The entire process of 3D printing could take up to a few days. This review shows that 3D printed kidney models are accurate in delineating renal anatomical structures and renal tumours with high accuracy. Patient-specific 3D printed models serve as a useful tool in preoperative planning and simulation of surgical procedures for treatment of renal tumours. Further studies with inclusion of more cases and with a focus on reducing the cost and 3D model production time deserve to be investigated.

Nanomedicines for renal disease: current status and future applications.

Treatment and management of kidney disease currently presents an enormous global burden, and the application of nanotechnology principles to renal disease therapy, although still at an early stage, has profound transformative potential. The increasing translation of nanomedicines to the clinic, alongside research efforts in tissue regeneration and organ-on-a-chip investigations, are likely to provide novel solutions to treat kidney diseases. Our understanding of renal anatomy and of how the biological and physico-chemical properties of nanomedicines (the combination of a nanocarrier and a drug) influence their interactions with renal tissues has improved dramatically. Tailoring of nanomedicines in terms of kidney retention and binding to key membranes and cell populations associated with renal diseases is now possible and greatly enhances their localization, tolerability, and efficacy. This Review outlines nanomedicine characteristics central to improved targeting of renal cells and highlights the prospects, challenges, and opportunities of nanotechnology-mediated therapies for renal diseases.

Renal Relevant Radiology

Ultrasound is commonly used in nephrology for diagnostic studies of the kidneys and lower urinary tract and to guide percutaneous procedures, such as insertion of hemodialysis catheters and kidney biopsy. Nephrologists must, therefore, have a thorough understanding of renal anatomy and the sonographic appearance of normal kidneys and lower urinary tract, and they must be able to recognize common abnormalities. Proper interpretation requires correlation with the clinical scenario. With the advent of affordable, portable scanners, sonography has become a procedure that can be performed by nephrologists, and both training and certification in renal ultrasonography are available.

Comparison between helical computed tomography angiography and intraoperative findings.

Background:Live donor nephrectomy has gained popularity on account of the laparoscopic technique, to overcome a small donor pool. Laparoscopic donor nephrectomy requires a precise study of the vascular and morphological renal anatomy, as laparoscopy is technically challenging due to the limited field of vision. In-depth knowledge of the renal anatomy before a laparoscopic procedure is essential for a successful transplant. The left kidney is preferred over the right even in cases of multiple vessels because of the long renal vein, which requires precise preoperative vascular mapping. Helical computerized tomography (CT) angiography, with its axial, coronal, and 3D reconstruction, gives a better understanding of renal anatomy. There are instances where the helical CT findings are misleading and less informative in a small number of cases. This study highlights a case study of the helical CT findings compared with the intraoperative findings of 200 live donors, who underwent laparoscopic donor nephrectomy, and the renal anatomy has been understood at the same time.Aims:1. To compare the helical CT findings on the operated side with the intraoperative findings. 2. To analyze the CT findingsMaterials and Methods:Two hundred cases of laparoscopic transperitoneal donor nephrectomy were included in this study.Statistical Method Used:Chi square test was the statistical test used to compare the findings between CT and the intraoperative data.Results:The axial, coronal, and 3D images of the CT findings were on par with the intraoperative findings in most of the cases. Incidental findings help in the better planning of surgery. Multiple vessels on the left side are preferred over the right sided normal anatomy; with not much technical difficulty with the aid of a helical CT. Male donors had more incidences of multiple vessels, gonadal vein, Retroaortic Renal Vein (RARV), lumbar vein, and duplication of ureter, compared to females. Furthermore, these variations are more in the left side donors. Ninety-two percent of the cases in this study are left-sided donors. The helical CT finding shows that renal vein variations are more on the right side.Conclusions:Helical CT is important in delineating the arterial, venous, and ureteral anatomy and can show the important incidental findings. Left renal donors and males have more variations in their renal anatomy. Technically challenging laparoscopic nephrectomy on the multiple-vessel-side donor is possible with the aid of helical CT. The importance of the CT in evaluating donor renal anatomy for a technically challenging laparoscopic donor nephrectomy is commendable.

Rapid Prototyping Model for Percutaneous Nephrolithotomy Training

Rapid prototyping is a technique used for creating computer images in three dimensions more efficiently than classic techniques. Percutaneous nephrolithotomy (PCNL) is a popular method to remove kidney stones; however, broader use by the urologic community has been hampered by the morbidity associated with needle puncture to gain access to the renal calix (bleeding, pneumothorax, hydrothorax, inadvertent colon injury). A training model to improve technique and understanding of renal anatomy could improve complications related to renal puncture; however, no model currently exists for resident training. We created a training model using the rapid prototyping technique based on abdominal CT images of a patient scheduled to undergo PCNL. This allowed our staff and residents to train on the model before performing the operation. This model allowed anticipation of particular difficulties inherent to the patient's anatomy. After training, the procedure proceeded without complication, and the patient was discharged at postoperative day 1 without problems. We hypothesize that rapid prototyping could be useful for resident education, allowing the creation of numerous models for research and surgical training. In addition, we anticipate that experienced urologists could find this technique helpful in preparation for difficult PCNL operations.