Laparoscopic partial nephrectomy using a technology of augmented reality: new vector of the development of operative urology?


DOI: https://dx.doi.org/10.18565/urology.2020.5.37-40

N.K. Gadjiev, R.R. Pogosyan, M.A. Ostanin, S.B. Petrov, I.V. Semenyakin

1Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation, Saint Petersburg, Russia; 2FGBNU Russian Scientific Center of Surgery named after Academician B.V. Petrovsky, Moscow, Russia; 3ANO VO «Innopolis University», Innopolis, Russia; 4FGBU FSBI “Academician V.I.Shumakov Federal Research Center of Transplantology and Artificial Organs”, Ministry of Health of the Russian Federation, Moscow, Russia
Aim: to evaluate the efficiency and usefulness of augmented reality (AR) technology using HoloLens glasses for laparoscopic partial nephrectomy (LPN).
Materials and methods. From July to December 2019, a total of 5 patients with localized kidney cancer (cT1aN0M0) underwent AR-assisted LRP. The mean RENAL score was 6 points (5–8). Preoperatively, all patients underwent contrast-enhanced multispiral computed tomography (MSCT). The three-dimensional reconstructions of the kidney, tumor, part of the abdominal aorta with the renal artery and its branches, part of the inferior vena cava with the renal vein were segmented with color coding and connected into a single virtual 3D model, which was loaded into the program in order to display image in AR glasses. The duration of surgery and thermal ischemia, type and frequency of intraoperative complications, as well as the time spent on preparing the 3D model and the Microsoft HoloLens device were evaluated. To assess the feasibility of using AR technology intraoperatively, a Likert scale was filled out by the surgeon.
Results. It took 10 (9-11) hours to prepare the model, including time to optimize the model and to set up its display and interactions. The setup of HoloLens required an average of 7.8 (5– 12) min. The total duration of the operation and the period of warm ischemia was 108 (90–120) and 20 (15–25) min, respectively, while intraoperative blood loss was 160 (110–250) ml. In all cases, a negative surgical margin was found. The surgeon who performed all the operations assessed the use of AR technology with the HoloLens device as highly beneficial in all clinical cases.
Conclusion. The use of AR technology with a HoloLens holographic device during LPN can lead to improved treatment outcomes.
Keywords: augmented reality, renal cell cancer, partial nephrectomy

About the Autors


Corresponding author: N.K. Gadjiev – urologist, Ph.D., MD, Head of the Department of Urology No2 (extracorporeal shock-wave lithotripsy and endovideosurgery) of Academician I.P. Pavlov First St. Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation, Saint Petersburg, Russia; e-mail: nariman.gadjiev@gmail.com


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