Editorial Comment on: Navigation of Intelligent/Interactive Qualitative and Quantitative Analysis Three-Dimensional Reconstruction Technique in Laparoscopic or Robotic Assisted Partial Nephrectomy for Renal Hilar Tumors by Wang et al. (From: Wang F, Zhang C, Guo F, et al. J Endourol 2019;33:641–646; DOI: 10.1089/end.2018.0570)

2019 ◽  
Vol 33 (8) ◽  
pp. 647-648
Author(s):  
Ahmed Ghazi
Keyword(s):  
Quantitative Analysis ◽  
Editorial Comment ◽  
Partial Nephrectomy ◽  
Three Dimensional ◽  
Reconstruction Technique ◽  
Qualitative And Quantitative Analysis ◽  
Robotic Assisted ◽  
Qualitative And Quantitative ◽  
Dimensional Reconstruction ◽  
Robotic Assisted Partial Nephrectomy

Clinical experience of using virtual 3D modelling for pre and intraoperative guidance during robotic-assisted partial nephrectomy

2021 ◽  
pp. 205141582110002
Author(s):  
Lorenz Berger ◽  
Aziz Gulamhusein ◽  
Eoin Hyde ◽  
Matt Gibb ◽  
Teele Kuusk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Partial Nephrectomy ◽  
Surgical Outcome ◽  
Prospective Cohort ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Dimensional Model ◽  
Three Dimensional Model ◽  
Robotic Assisted ◽  
Robotic Assisted Partial Nephrectomy

Objective: Surgical planning for robotic-assisted partial nephrectomy is widely performed using two-dimensional computed tomography images. It is unclear to what extent two-dimensional images fully simulate surgical anatomy and case complexity. To overcome these limitations, software has been developed to reconstruct three-dimensional models from computed tomography data. We present the results of a feasibility study, to explore the role and practicality of virtual three-dimensional modelling (by Innersight Labs) in the context of surgical utility for preoperative and intraoperative use, as well as improving patient involvement. Methods: A prospective study was conducted on patients undergoing robotic-assisted partial nephrectomy at our high volume kidney cancer centre. Approval from a research ethics committee was obtained. Patient demographics and tumour characteristics were collected. Surgical outcome measures were recorded. The value of the three-dimensional model to the surgeon and patient was assessed using a survey. The prospective cohort was compared against a retrospective cohort and cases were individually matched using RENAL (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, location relative to polar lines) scores. Results: This study included 22 patients. Three-dimensional modelling was found to be safe for this prospective cohort and resulted in good surgical outcome measures. The mean (standard deviation) console time was 158.6 (35) min and warm ischaemia time was 17.3 (6.3) min. The median (interquartile range) estimated blood loss was 125 (50–237.5) ml. Two procedures were converted to radical nephrectomy due to the risk of positive margins during resection. The median (interquartile range) length of stay was 2 (2–3) days. No postoperative complications were noted and all patients had negative surgical margins. Patients reported improved understanding of their procedure using the three-dimensional model. Conclusion: This study shows the potential benefit of three-dimensional modelling technology with positive uptake from surgeons and patients. Benefits are improved perception of vascular anatomy and resection approach, and procedure understanding by patients. A randomised controlled trial is needed to evaluate the technology further. Level of evidence: 2b

scholarly journals Simulación de Mecanismos

2019 ◽  
pp. 20-27
Author(s):  
Homero Jiménez-Rabiela ◽  
Benjamín Vázquez-González ◽  
José Luis Ramírez-Cruz ◽  
Pedro García-Segura
Keyword(s):  
Quantitative Analysis ◽  
Cognitive Process ◽  
Degrees Of Freedom ◽  
Three Dimensional ◽  
Qualitative And Quantitative Analysis ◽  
Mechanical Advantage ◽  
Qualitative And Quantitative

Objectives: In this work we show different simulated mechanisms virtually, their objective is to facilitate the qualitative and quantitative analysis of their kinematics; allowing to determine degrees of freedom, relation of times, mechanical advantage, mobility, positions, speeds and accelerations. Such an objective is achieved by simulating them for different positions using discretization and variable timing. Methodology: It consists of files of mechanisms with the corresponding files of links and electronic spreadsheets. The student must modify the dimensional, geometric and kinematic restrictions; remove them and install new ones; to observe the behavior of the mechanism as a system or of the links as integral parts. Contribution: Simplify the cognitive process of the kinematics of the mechanisms. It facilitates the understanding of the Euler and the Lagrange approaches. It allows to understand and evaluate the positions, speeds and accelerations; absolute, relative and apparent. The files of mechanisms and links are virtual, three-dimensional and allow their animation. Electronic spreadsheets control the restrictions of both the mechanisms and their links.

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