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Related Experiment Video

Updated: Jan 25, 2026

Robot-assisted Partial Splenectomy

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Published on: January 2, 2026

Robot-assisted Partial Nephrectomy with and without Mixed Reality - REALITATEM study.

Dorival Manrique Duarte^1,2, Pietro Waltrick Brum³, Milton Berger^1,2

¹Universidade Federal do Rio Grande do Sul - UFRS, Porto Alegre, RS, Brasil.

International Braz J Urol : Official Journal of the Brazilian Society of Urology

|January 23, 2026

Summary

Mixed Reality (MIXREAL) shows promise in robot-assisted partial nephrectomy (RAPN) by reducing ischemia time and aiding surgical decisions. Further research is needed to confirm long-term functional benefits in renal masses.

Keywords:

Augmented Reality Nephrectomy Robotic Surgical Procedures

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Area of Science:

Urology
Surgical Technology
Medical Imaging

Background:

Robot-assisted partial nephrectomy (RAPN) is a standard procedure for renal masses.
Minimizing renal ischemia time is crucial for preserving renal function.
Intraoperative decision-making can be challenging in complex RAPN cases.

Purpose of the Study:

To evaluate the efficacy of Mixed Reality (MIXREAL), combining virtual (VR) and augmented realities (AR), in RAPN.
To assess the impact of MIXREAL on key surgical parameters and patient outcomes.
To determine the feasibility and safety of integrating MIXREAL into RAPN procedures.

Main Methods:

A randomized clinical trial (RCT) involving 45 patients with renal masses.
Patients were assigned to RAPN with (Realitatem Group - RG) or without (Control Group - CG) MIXREAL.
Outcomes included ischemia time, selective clamping decisions, residual parenchyma, complication rates, and renal function.

Main Results:

The MIXREAL group (RG) demonstrated a statistically significant reduction in ischemia time (p = 0.045) by an average of 3.8 minutes.
RG showed a significant improvement in decisions for selective renal artery clamping (p = 0.013), potentially reducing parenchymal ischemia.
A trend towards facilitated enucleation techniques was observed in the RG, but no differences in complication rates or short/long-term renal function were detected. The study's small sample size is a limitation.

Conclusions:

This RCT confirms the feasibility and safety of using MIXREAL in RAPN.
MIXREAL shows potential to enhance intraoperative decision-making during RAPN.
Larger studies with extended follow-up are necessary to validate the potential functional benefits of MIXREAL in RAPN.