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• W2017472404 abstract "You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal1 Apr 20111684 SURGICAL PLANNING OF PERCUTANEOUS NEPHROLITHOTOMY USING 3D PATIENT SPECIFIC MODELS Jagadeesan Jayender, Rivka Colen, Kirby Vosburgh, Ferenc Jolesz, and Dianne Sacco Jagadeesan JayenderJagadeesan Jayender Boston, MA More articles by this author , Rivka ColenRivka Colen Boston, MA More articles by this author , Kirby VosburghKirby Vosburgh Boston, MA More articles by this author , Ferenc JoleszFerenc Jolesz Boston, MA More articles by this author , and Dianne SaccoDianne Sacco Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1861AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous Nephrolithotomy (PCNL) is one of the modalities used to treat large kidney stones or stones in patients with anatomical anomalies. The procedure is challenging due to the difficulty in accessing and removing the entire stone. Here we analyze the potential of 3D patient-specific models for improving the clinician's performance in localizing the kidney stones. METHODS Seven human subjects with CT identified stones scheduled to undergo PCNL were selected. In four cases (Group G1), 3D patient specific models were created and shown to the clinician prior to the procedure; the remaining three patients (G2) underwent PCNL without any surgical planning. A radiologist created 3D patient specific models of the abdomen and pelvis in the open source software, 3D Slicer. An optional virtual endoscopic view was also provided to the clinician. Based on the 3D models, the volume of the kidney stones, the distance of the stone from the puncture location and the angle between the access site and stones in adjacent calyces were calculated. A validated NASA task load (TL) assessment questionnaire was completed following each examination to assess the clinician's ease of localizing the stone and finding the adjacent stones. RESULTS Seven subjects underwent PCNL without any major complications. The average volume of the kidney stones was 5.4cc. The difficulty of the procedure in G1 and G2 was similar (binary values assigned for each of the following factors – no., vol. and position of the stones, previous surgeries, neurological disorders and anatomical aberrancy). For G1, the procedure was completed efficiently (TL Temporal Demand diff. 12.1%), with less stress (TL Effort diff. 28.7%, TL Frustration diff. 30.7%) compared to G2. The mental and physical demand were also lower in G1 compared to G2 by 13.5% and 15.4%. CONCLUSIONS Surgical planning using 3D patient specific anatomic models appears to reduce the mental, temporal and physical demand on the clinician. Work is underway to display the position of the surgical instrument in real time registered to the 3D models, thereby providing additional guidance for the surgeon. Figure 1 (a)–(e) Pelvic anatomy with distance measurement (98.6mm) of the stone from the puncture location, and the angle (113 deg) between the access site and stones in adjacent calyces (f) virtual endoscopic view. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e677 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jagadeesan Jayender Boston, MA More articles by this author Rivka Colen Boston, MA More articles by this author Kirby Vosburgh Boston, MA More articles by this author Ferenc Jolesz Boston, MA More articles by this author Dianne Sacco Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2017472404 title "1684 SURGICAL PLANNING OF PERCUTANEOUS NEPHROLITHOTOMY USING 3D PATIENT SPECIFIC MODELS" @default.
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