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The clinical application value of mixed-reality-assisted surgical navigation for laparoscopic nephrectomy
Guan Li1, Jie Dong2, Jinbao Wang3
1Department of Radiology, Jinling Hospital, Nanjing Medical University, Nanjing, China.
Purpose:
Laparoscopic nephrectomy (LN) has become the preferred method for renal cell carcinoma (RCC). Adequate preoperative assessment or intraoperative navigation is key to the successful implementation of LN. The aim of this study was to evaluate the clinical application value of mixed-reality-assisted surgical navigation (MRASN) in LN.
Patients And Methods:
A total of 100 patients with stage T1N0M0 renal tumors who underwent laparoscopic partial nephrectomy (LPN) or laparoscopic radical nephrectomy (LRN) were prospectively enrolled and divided into a mixed-reality-assisted laparoscopic nephrectomy (MRALN) group (n = 50) and a non-mixed-reality-assisted laparoscopic nephrectomy (non-MRALN) group (n = 50). All patients underwent renal contrast-enhanced CT scans. The CT DICOM data of all patients in the MRALN group were imported into the mixed-reality (MR) postprocessing workstation and underwent holographic three-dimensional visualization (V3D) modeling and MR displayed, respectively. We adopted the Likert scale to evaluate the clinical application value of MRASN. The consistency of evaluators was assessed using the Cohen kappa coefficient (k).
Results:
No significant differences in patient demographic indicators between the MRALN group and the non-MRALN group (P > .05). The subjective score of MRASN clinical application value in operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor-patient communication were higher in the MRASN group than in the non-MRASN group (all P < .001). There were significantly more patients for whom LPN was successfully implemented in the MRALN group than in the non-MRALN group (82% vs 46%, P < .001). The MRALN group had a shorter operative time (OT) and warm ischemia time (WIT) and less estimated blood loss (EBL) than the non-MRALN group (all P < .001).
Conclusion:
MRASN is helpful for operative plan formulation, intraoperative navigation, remote consultation, teaching guidance, and doctor-patient communication. MRALN may effectively improve the successful implementation rate of LPN and reduce the OT, WIT, and EBL.
