Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy: A controlled study

Area of Science:

• Urology
• Medical Technology
• Surgical Navigation

Background:

• Percutaneous nephrolithotomy (PCNL) is the primary treatment for complex renal stones.
• Surgeons face challenges in PCNL due to poor understanding of adjacent anatomical structures.
• Advanced techniques are needed for improved planning and navigation in PCNL procedures.

Purpose of the Study:

• To evaluate the effectiveness of the Hisense computer-assisted surgery (CAS) system in PCNL procedures.
• To compare CAS-assisted PCNL with standard PCNL for complex renal stones.

Main Methods:

• A study included 60 patients with complex renal stones, divided into a CAS group (30 patients) and a control group (30 patients).
• The CAS group utilized three-dimensional (3D) virtual models for planning and navigation.
• Standard PCNL procedures were performed in the control group without CAS assistance.

Main Results:

• The CAS group showed a significantly higher success rate for one-attempt puncturing (90% vs. 67%) and initial stone-free rate (87% vs. 63%).
• No significant differences were observed in operation time or hemoglobin decrease between the groups.
• The incidence of complications (Clavien-Dindo grade ≥ 2) did not differ significantly between the CAS and control groups.

Conclusions:

• CAS-assisted PCNL demonstrates superior puncturing success and stone-free rates compared to standard PCNL.
• The Hisense CAS system is recommended for enhancing preoperative planning and intraoperative navigation in PCNL.
• CAS provides an intuitive, precise, and convenient approach for PCNL procedures.