■经皮肾镜取石术(PCNL)是泌尿外科脓肾或碎石术的主要方法。然而,它往往伴随着高风险,因为不准确的穿刺不可避免地导致出血,术中和术后并发症。所以,需要一种新的跨学科方法来更准确地进行穿刺.
■在家猪或患者腰部后侧的皮肤上标记了3个由铅制成的迹象,通过计算机断层扫描(CT)扫描。根据CT图像,电脑设计和3D打印,构造由透明树脂材料制成的导航模板。根据体征将它们附着在猪或患者的手术区域上。在PCNL期间,有了这个模板,穿刺位置,角度和深度进行了优化,以精确地进入目标肾盂或钙。
■使用3D导航模板,在对猪模型和患者进行PCNL后,使用18G穿刺针进入肾盂。在猪模型上,观察到尿液流出,并发症最少。术后CT扫描显示针头位于肾盂中。对于病人来说,穿刺点被设计成用石头瞄准杯。肾模板穿刺未见明显出血及并发症。
■导航模板是结合3D打印制作的,CT图像和计算机设计。该模板允许精确穿刺肾盂或杯。在猪模型和患者病例中观察到肾结石和脓肾的手术改善。在未来,prospective,转移,临床对照试验需要进一步证实其优势。
UNASSIGNED: Percutaneous nephrolithotomy (PCNL) is the main method for pyonephrosis or lithotripsy in urology. However, it often comes with high risk, as the inaccurate puncture inevitably causes bleeding, intra- and post-operative complications. So, a new inter-disciplinary approach is needed to perform the puncture more accurately.
UNASSIGNED: 3 signs made of lead were marked onto the skin of the posterior side of the waist of a domestic pig or a patient, which was scanned by computed tomography (CT). Based on the CT images, the computer design and the 3D printing, a navigation template made of the transparent resin material is constructed. They were attached onto the surgical area on pig or patient according to the signs. During the PCNL, with this template, the puncture position, angle and depth were optimized in order to precisely enter the targeted renal pelvis or calices.
UNASSIGNED: With the 3D navigation templates, 18G puncture needles were used to enter the renal pelvis upon performing the PCNL on a porcine model and a patient. On the porcine model, the urine outflow was observed with minimal complication. Post-operative CT scans revealed that the needle was located in the renal pelvis. For the patient case, the puncture point was designed to target the calix with stone. No obvious bleeding and complication was found in renal puncture with template.
UNASSIGNED: The navigation template was made with the combination of 3D printing, CT images and computer design. This template allows for accurate puncture of the renal pelvis or calix. Surgical improvement in kidney stones and pyonephrosis was observed in porcine model and patient case. In the future, prospective, trandomized, controlled clinical trials are needed to further confirm its advantage.