Application of virtual reality in optimizing surgical outcomes and resident training in percutaneous nephrolithotomy:...

Percutaneous nephrolithotomy (PCNL) necessitates that the urologist comprehensively understands the stone's location and its relation to the intrarenal anatomy. We evaluated the use of virtual reality (VR) as a preoperative tool for planning for PCNL surgery and its assessment for training among residents in PCNL.

This prospective, randomized control trial took place between May 2021 to June 2022. Resident and consultant surgeons rated their understanding of the anatomy with computed tomography (CT) alone and after CT+VR. The CT scans from patients randomized to the intervention group created a patient-specific three-dimensional VR model (Anatomage software version 6.02).

The trial enrolled 90 participants and was randomized to the control group (CT alone) and the VR group. The mean age of the participants was 42.09±13.48 years. There were 63 males (70.0%) and 27 females (30.0%). Residents had an improved understanding of the location of the stone, size of the stone, shape, orientation of the calyx, optimal entry of the calyx, and navigation. Residents had a better ability to formulate a surgical plan with VR models. The consultant surgeon's assessment showed CT and VR had non-significant results for understanding based on the above parameters. Preoperative evaluation in patients in the VR group with S.T.O.N.E score >8 showed a statistically significant better understanding of consultants (p<0.05). They recommend VR to colleagues if patients have a S.T.O.N.E score >8 (p<0.05).

VR improved the understanding of PCNL for residents in all cases and consultants in complex anatomy cases.