Factors affecting the use of a three-dimensional model during robot-assisted partial nephrectomy

Area of Science:

• Urology
• Surgical Technology
• Medical Imaging

Background:

• Robot-assisted partial nephrectomy (RAPN) is a complex procedure for renal tumors.
• The utility of 3D-printed kidney models in RAPN requires further investigation.
• Identifying specific indications for 3D model use can optimize surgical planning.

Purpose of the Study:

• To determine the specific clinical scenarios where 3D-printed kidney models are most valuable during RAPN.
• To analyze surgeon consultation frequency and duration of 3D model use.
• To identify patient and tumor characteristics associated with 3D model utilization.

Main Methods:

• 93 patients undergoing RAPN for renal tumors were analyzed.
• Intraoperative video assessed surgeon consultation frequency and duration of 3D model use.
• Multivariate analyses correlated 3D model use with preoperative characteristics, including renal vascular complexity.

Main Results:

• Median 3D model consultation was 4 times, lasting 39 seconds.
• Frequency and duration of 3D model use significantly correlated with complex arterial structures (≥4 branches) and hilar tumors.
• High Mayo Adhesive Probability score also predicted increased consultation frequency.

Conclusions:

• 3D-printed kidney models are beneficial in RAPN for cases involving complex arterial anatomy.
• The presence of a hilar tumor is another key indicator for the utility of 3D models.
• These findings help refine indications for 3D model use in partial nephrectomy.