Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6039-6049
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6039
Application of a novel computer-assisted surgery system in percutaneous nephrolithotomy: A controlled study
Fei Qin, Ye-Feng Sun, Xin-Ning Wang, Bin Li, Zhi-Lei Zhang, Ming-Xin Zhang, Fei Xie, Shuai-Hong Liu, Zi-Jie Wang, Yuan-Chao Cao, Wei Jiao
Fei Qin, Ye-Feng Sun, Xin-Ning Wang, Bin Li, Zhi-Lei Zhang, Ming-Xin Zhang, Fei Xie, Shuai-Hong Liu, Zi-Jie Wang, Yuan-Chao Cao, Wei Jiao, Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Author contributions: All authors contributed to the study conception and design; Data collection was performed by Sun YF and Zhang ZL; Data analysis was performed by Qin F, Zhang MX and Xie F; Figure collection and processing was performed by Liu SH and Wang ZJ; Cao YC and Jiao W provided clinical advice; Wang XN and Li B revised the manuscript according to comments; The first draft of the manuscript was written by Qin F and all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript.
Supported by the Science and Technology Program in Chinese Medicine of Shandong Province, No. 2020M074.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Qingdao University, No. QYFYWZLL26370.
Informed consent statement: Informed consent was obtained from the patient in this study.
Conflict-of-interest statement: The authors had no conflict-of-interest to declare that are relevant to the content of this article.
Data sharing statement: The de-identified data will be shared on reasonable request to the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Jiao, MMed, Associate Chief Physician, Associate Professor, Deputy Director, Department of Urology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266000, Shandong Province, China. jiaowei3929@163.com
Received: December 13, 2021
Peer-review started: December 13, 2021
First decision: February 14, 2022
Revised: March 1, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: June 26, 2022
Processing time: 185 Days and 14.3 Hours
Abstract
BACKGROUND

Most complex renal stones are managed primarily with percutaneous nephrolithotomy (PCNL). However, PCNL is still a great challenge for surgeons because of poor comprehension on complex adjacent structures. Novel techniques are required to assist in planning and navigation.

AIM

To apply and evaluate the Hisense computer-assisted surgery (CAS) system in PCNL.

METHODS

A total of 60 patients with complex renal stones were included. Thirty patients in the CAS group had three-dimensional (3D) virtual models constructed with the CAS system. The model assisted in planning and navigating in the CAS system. Thirty patients in the control group planned and navigated as standard PCNL, without the application of the CAS system. Success rate of one attempt, operation time, initial stone-free rate, decrease in hemoglobin, and complications were collected and analyzed.

RESULTS

There were no statistically significant differences in the baseline characteristics or planning characteristics. The success rate of one puncturing attempt (90% vs 67%, P = 0.028) and the initial stone-free rate (87% vs 63%, P = 0.037) were significantly higher in the CAS group. However, there were no statistically significant differences in the operation time (89.20 ± 29.60 min vs 92.33 ± 33.08 min, P = 0.859) or in the decrease in hemoglobin (11.07 ± 8.32 g/L vs 9.03 ± 11.72 g/L, P = 0.300) between the CAS group and the control group. No statistically significant differences in the incidence of complications (Clavien-Dindo grade ≥ 2) were found.

CONCLUSION

Compared with standard PCNL, CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate. The Hisense CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive, precise and convenient PCNL.

Keywords: Computer-assisted surgery system; Percutaneous nephrolithotomy; Three-dimensional reconstruction; Planning; Navigation

Core Tip: Consisting of construction, display, simulation and measurement functions, the Hisense computer-assisted surgery (CAS) system is a novel and all-around software based on new generation of three-dimensional (3D) reconstruction. Compared with standard percutaneous nephrolithotomy (PCNL), CAS-assisted PCNL had advantages in terms of the puncturing success rate and stone-free rate. The CAS System was recommended to assist in preoperative planning and intraoperative navigation for an intuitive, precise and convenient PCNL.