通过皮肤结石切除术的图像指导手术规划与患者特定的CTR
Filipe C Pedrosa1,2, Navid Feizi3,4, Ruisi Zhang5,6
1Western University, London, Canada. fpedrosa@uwo.ca.
International journal of computer assisted radiology and surgery
|October 26, 2023
概括
优化用于结石的患者特定的同心管机器人 (CTR) 显示出减少皮肤穿神经切除术 (PCNL) 的并发症的前景. 这种方法旨在实现单一的手术通道,改善与传统方法相比的访问.
科学领域:
- 医疗机器人 医疗机器人
- 泌尿外科手术 泌尿外科手术
- 脊髓石切除术 (nephrolithotomy) 是一个切除术.
背景情况:
- 皮肤穿神经切除术 (PCNL) 程序带有显著的疾病.
- 目前的PCNL技术可能面临复杂的结石解剖学方面的挑战.
研究的目的:
- 建议针对患者的同心管机器人 (CTR) 优化,以提高结石的体积可达性.
- 通过优化皮肤穿接入和CTR设计来减少与PCNL相关的发病率.
主要方法:
- 利用嵌套优化驱动的方案来确定用于CTR部署的单个外科通道.
- 采用圆形近似的结石和网格搜索最佳的接入点.
- 进行了敏感性分析,考虑了由于呼吸和工具与组织相互作用而引起的脏运动.
- 通过使用临床数据,比较算法生成的皮肤穿接入与专家泌尿科医生的皮肤穿接入.
主要成果:
- 专家泌尿科医生评估发现,算法生成的皮肤穿透通道与专家外科医生的通道相当.
- 模拟结果显示显著的体积覆盖,即使由于呼吸或工具-组织相互作用,脏外流1厘米.
结论:
- 优化驱动的方案和患者特定的CTR显示了改善PCNL皮肤穿接入的潜力.
- 这种方法可以提高鹿角石和非鹿角石的质量和适用性.
- 需要进一步的临床验证来确认发现并探索临床益处.
相关概念视频
Urinary Tract Calculi VI: Surgical Management
8
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
8
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
37
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
37
Urinary Tract Calculi V: Nursing Management
12
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
12
Imaging Studies III: Computed Tomography
12
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
12
Imaging Studies I: Kidney, Ureter, and Bladder Studies
11
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
11
Imaging Studies II: Ultrasonography
14
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
14


