Surgical planning and manual image fusion based on 3D model facilitate laparoscopic partial nephrectomy for intrarenal tumors

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• 作者：Yuanbo Chen (1)
  Hulin Li (2)
  Dingtao Wu (1)
  Keming Bi (1)
  Chunxiao Liu (2)
  
• 关键词：Partial nephrectomy ; Intrarenal tumors ; Surgical planning ; Image fusion ; 3D ; Morphometry
• 刊名：World Journal of Urology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：32
• 期：6
• 页码：1493-1499
• 全文大小：1,202 KB
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• 作者单位：Yuanbo Chen (1)
  Hulin Li (2)
  Dingtao Wu (1)
  Keming Bi (1)
  Chunxiao Liu (2)
  
  1. Department of Urology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530001, Guangxi, People’s Republic of China
  2. Department of Urology, Zhujiang Hospital of Southern Medical University, No. 253 Industrial Rd., Guangzhou, 510282, Guangdong, People’s Republic of China
  
• ISSN：1433-8726

文摘

Purpose Construction of three-dimensional (3D) model of renal tumor facilitated surgical planning and imaging guidance of manual image fusion in laparoscopic partial nephrectomy (LPN) for intrarenal tumors. Materials and methods Fifteen patients with intrarenal tumors underwent LPN between January and December 2012. Computed tomography-based reconstruction of the 3D models of renal tumors was performed using Mimics 12.1 software. Surgical planning was performed through morphometry and multi-angle visual views of the tumor model. Two-step manual image fusion superimposed 3D model images onto 2D laparoscopic images. The image fusion was verified by intraoperative ultrasound. Imaging-guided laparoscopic hilar clamping and tumor excision was performed. Manual fusion time, patient demographics, surgical details, and postoperative treatment parameters were analyzed. Results The reconstructed 3D tumor models accurately represented the patient’s physiological anatomical landmarks. The surgical planning markers were marked successfully. Manual image fusion was flexible and feasible with fusion time of 6?min (5-?min). All surgeries were completed laparoscopically. The median tumor excision time was 5.4?min (3.5-0?min), whereas the median warm ischemia time was 25.5?min (16-2?min). Twelve patients (80?%) demonstrated renal cell carcinoma on final pathology, and all surgical margins were negative. No tumor recurrence was detected after a media follow-up of 1?year (3-5?months). Conclusions The surgical planning and two-step manual image fusion based on 3D model of renal tumor facilitated visible-imaging-guided tumor resection with negative margin in LPN for intrarenal tumor. It is promising and moves us one step closer to imaging-guided surgery.