MP29-04: Application of optical tracking sensing technology in fusion of image puncture and 3D navigation lithotripsy of ultrasound-guided PCNL
Saturday, May 4, 2024 9:30 AM to 11:30 AM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Yubao Liu*, Haifeng Song, Wang Bi xiao, Jianxing Li, Beijing, China
Introduction
To explore and evaluate the safety, effectiveness, and application value of using optical tracking sensing technology for ultrasound-CT fusion image puncture and 3D image navigation lithotripsy in ultrasound-guided PCNL
Methods
This is a prospective cohort study that included the analysis of clinical data from 46 patients with staghorn kidney stones. Patients were randomly divided into an optical tracking technology group (OTT), which uses OTT to guide ultrasound-CT fusion image puncture combined with 3D navigation lithotripsy and a conventional technology group (CT), which uses a single ultrasound positioning puncture combined with conventional lithotripsy. The two groups of patients were 42.3±6.1 years old and 45.2±3.7 years old, with BMI of 24.2±2.6 kg/m2 and 25.9±2.8 kg/m2, and maximum diameter of stones of 4.1 ± 0.6cm and 4.3 ± 0.5cm. The operation method for the OTT group is as follows. Patient's 3D reconstruction of CT image was imported into the ultrasound device. During the intraoperative puncture, an optical sensor is placed on the ultrasound probe to obtain the position information of the probe, and the spatial matching of the coordinate system is used to calculate the position and orientation information of the ultrasound section in the 3D CT image, thereby obtaining real-time ultrasound-CT 3D fusion images, guiding the completion of puncture. During the lithotripsy process, optical sensors are fixed at the operating end of the nephroscope to obtain real-time spatial coordinate information of the endoscope, and projected onto the corresponding positions in the 3Dl CT image of the kidney, completing the 3D visualization of spatial navigation for lithotripsy. Design a questionnaire to evaluate the subjective satisfaction of the surgeon with OTT assisted PCNL. Compare and analyze the main indicators (main channel positioning puncture time, lithotripsy time, SFR, and satisfaction score) and secondary indicators (hemoglobin decrease, postoperative VAS score, incidence of postoperative serious complications, and postoperative hospitalization days) of the two groups.
Results
46 surgeries were successfully performed. The main channel positioning puncture time was 28.1 ± 5.2 seconds versus 39.4 ± 2.7 seconds, and the lithotripsy time was 48.2 ± 6.2 minutes versus 61.1 ± 8.3 minutes. The SFR was 91.3% (21/23) versus 71.4% (18/23), and the satisfaction score was 94.2 points versus 81.6 points. The differences between the above two groups were statistically significant (P<0.05). The hemoglobin drop was 3.5 ± 0.4 g/L versus 3.8 ± 0.2 g/L, VAS score was 3.1 ± 0.6 versus 3.3 ± 0.2, and postoperative hospitalization days were 5.7 ± 0.6 d versus 6.1 ± 0.3 d. There was no statistical significance in the difference between the groups of the above indexes (P > 0.05), and there were no Clavien-Dindo = grade II complications in either group.
Conclusions
The anatomical structure of staghorn kidney stones is complex, and the difficulty of ultrasound guided PCNL puncture technique is high. The postoperative residual stone rate and complications are high. The use of OTT can achieve rapid and real-time fusion of image guided puncture and 3D image navigation lithotripsy, reducing the difficulty of puncture, improving surgical efficiency, and effectively improving the SFR, thus achieving controllable and precise surgery.
Source Of Funding
no
Author Block
Yubao Liu*, Haifeng Song, Wang Bi xiao, Jianxing Li, Beijing, China
Introduction
To explore and evaluate the safety, effectiveness, and application value of using optical tracking sensing technology for ultrasound-CT fusion image puncture and 3D image navigation lithotripsy in ultrasound-guided PCNL
Methods
This is a prospective cohort study that included the analysis of clinical data from 46 patients with staghorn kidney stones. Patients were randomly divided into an optical tracking technology group (OTT), which uses OTT to guide ultrasound-CT fusion image puncture combined with 3D navigation lithotripsy and a conventional technology group (CT), which uses a single ultrasound positioning puncture combined with conventional lithotripsy. The two groups of patients were 42.3±6.1 years old and 45.2±3.7 years old, with BMI of 24.2±2.6 kg/m2 and 25.9±2.8 kg/m2, and maximum diameter of stones of 4.1 ± 0.6cm and 4.3 ± 0.5cm. The operation method for the OTT group is as follows. Patient's 3D reconstruction of CT image was imported into the ultrasound device. During the intraoperative puncture, an optical sensor is placed on the ultrasound probe to obtain the position information of the probe, and the spatial matching of the coordinate system is used to calculate the position and orientation information of the ultrasound section in the 3D CT image, thereby obtaining real-time ultrasound-CT 3D fusion images, guiding the completion of puncture. During the lithotripsy process, optical sensors are fixed at the operating end of the nephroscope to obtain real-time spatial coordinate information of the endoscope, and projected onto the corresponding positions in the 3Dl CT image of the kidney, completing the 3D visualization of spatial navigation for lithotripsy. Design a questionnaire to evaluate the subjective satisfaction of the surgeon with OTT assisted PCNL. Compare and analyze the main indicators (main channel positioning puncture time, lithotripsy time, SFR, and satisfaction score) and secondary indicators (hemoglobin decrease, postoperative VAS score, incidence of postoperative serious complications, and postoperative hospitalization days) of the two groups.
Results
46 surgeries were successfully performed. The main channel positioning puncture time was 28.1 ± 5.2 seconds versus 39.4 ± 2.7 seconds, and the lithotripsy time was 48.2 ± 6.2 minutes versus 61.1 ± 8.3 minutes. The SFR was 91.3% (21/23) versus 71.4% (18/23), and the satisfaction score was 94.2 points versus 81.6 points. The differences between the above two groups were statistically significant (P<0.05). The hemoglobin drop was 3.5 ± 0.4 g/L versus 3.8 ± 0.2 g/L, VAS score was 3.1 ± 0.6 versus 3.3 ± 0.2, and postoperative hospitalization days were 5.7 ± 0.6 d versus 6.1 ± 0.3 d. There was no statistical significance in the difference between the groups of the above indexes (P > 0.05), and there were no Clavien-Dindo = grade II complications in either group.
Conclusions
The anatomical structure of staghorn kidney stones is complex, and the difficulty of ultrasound guided PCNL puncture technique is high. The postoperative residual stone rate and complications are high. The use of OTT can achieve rapid and real-time fusion of image guided puncture and 3D image navigation lithotripsy, reducing the difficulty of puncture, improving surgical efficiency, and effectively improving the SFR, thus achieving controllable and precise surgery.
Source Of Funding
no