METHODS: Children diagnosed with urological conditions necessitating complex procedures were retrospectively reviewed and enrolled in the study. Patient-specific VR simulations were developed with medical imaging specialists and VR technology experts. Routine CT images were utilized to create a VR environment using advanced software platforms. The accuracy and fidelity of the VR simulations was validated through a multi-step process. This involved comparing the virtual anatomical models to the original medical imaging data and conducting feedback sessions with pediatric urology experts to assess VR simulations\' realism and clinical relevance.
RESULTS: A total of six pediatric patients were reviewed. The median age of the participants was 5.5 years (IQR: 3.5-8.5 years), with an equal distribution of males and females across both groups. A minimally invasive laparoscopic approach was performed for adrenal lesions (n = 3), Wilms\' tumor (n = 1), bilateral nephroblastomatosis (n = 1), and abdominal trauma in complex vascular and renal malformation (ptotic and hypoplastic kidney) (n = 1). Key benefits included enhanced visualization of the segmental arteries and the deep vascularization of the kidney and adrenal glands in all cases. The high depth perception and precision in the orientation of the arteries and veins to the parenchyma changed the intraoperative decision-making process in five patients. Preoperative VR patient-specific simulation did not offer accuracy in studying the pelvic and calyceal anatomy.
CONCLUSIONS: VR patient-specific simulations represent an empowering tool in pediatric urology. By leveraging the immersive capabilities of VR technology, preoperative planning and intraoperative navigation can greatly impact surgical decision-making. As we continue to advance in medical simulation, VR holds promise in educational programs to include even surgical treatment of more complex urogenital malformations.
方法:对被诊断为泌尿系疾病且需要进行复杂手术的儿童进行回顾性分析并纳入研究。特定于患者的VR模拟是由医学影像专家和VR技术专家开发的。常规CT图像用于使用高级软件平台创建VR环境。通过多步骤过程验证了VR模拟的准确性和保真度。这包括将虚拟解剖模型与原始医学成像数据进行比较,并与儿科泌尿科专家进行反馈会议,以评估VR模拟的真实性和临床相关性。
结果:对总共6例儿科患者进行了回顾。参与者的平均年龄为5.5岁(IQR:3.5-8.5岁),两组的男性和女性分布相等。对肾上腺病变进行了微创腹腔镜手术(n=3),肾母细胞瘤(n=1),双侧肾母细胞瘤病(n=1),复杂血管和肾脏畸形(肾破裂和发育不良)的腹部创伤(n=1)。在所有情况下,主要益处包括增强节段动脉的可视化以及肾脏和肾上腺的深血管化。动脉和静脉向实质方向的高深度感知和精度改变了五名患者的术中决策过程。术前VR患者特异性模拟在研究骨盆和肾盂解剖结构方面没有提供准确性。
结论:VR患者特异性模拟代表了儿科泌尿外科的授权工具。通过利用VR技术的沉浸式功能,术前计划和术中导航可以极大地影响手术决策。随着我们在医学模拟方面的不断进步,VR在教育计划中有望包括甚至更复杂的泌尿生殖道畸形的手术治疗。