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- Title
Expanding the Indications of Robotic Partial Nephrectomy for Highly Complex Renal Tumors: Urologists' Perception of the Impact of Hyperaccuracy Three-Dimensional Reconstruction.
- Authors
Bertolo, Riccardo; Autorino, Riccardo; Fiori, Cristian; Amparore, Daniele; Checcucci, Enrico; Mottrie, Alexandre; Porter, James; Haber, Georges-Pascal; Derweesh, Ithaar; Porpiglia, Francesco
- Abstract
<bold>Objectives: </bold>To assess the role of three-dimensional (3D) reconstruction in aiding preoperative planning for highly complex renal tumors amenable to robotic partial nephrectomy (RPN).<bold>Materials and Methods: </bold>Computed tomography (CT) scans and respective 3D reconstructions of 20 highly complex renal tumors were displayed to the attendees/urologists of the 6th Techno-Urology Meeting ( www.technourologymeeting.com ). These 20 cases had already undergone RPN performed by a single experienced surgeon. The attendees were asked to watch the videos of the CT scans first, and then the respective 3D reconstructions of 5 of the 20 cases who were randomly selected. A purpose-built questionnaire collected responders' surgical experience and surgical indication (RPN versus nephrectomy) after viewing the CT scan and the respective 3D reconstructions.<bold>Results: </bold>Twenty expert urologists, 27 young urologists, and 61 residents (total = 108) participated in the study. Five hundred forty-two views of the cases were obtained. Based on CT scans, RPN was indicated in 256 cases (47.2%). After viewing the respective 3D reconstructions, in 148 cases the responders changed their idea: indication to RPN raised in 404 cases (74.5%) (P < .001). The opinions changed regardless of the surgical experience.<bold>Conclusions: </bold>The findings of this study are encouraging, and they might represent a significant step toward the validation of the use of 3D reconstruction for surgical planning in patients undergoing robotic kidney surgery. The use of this technology might translate into a larger adoption of nephron-sparing approach. Further investigation in this area is warranted to corroborate these findings.
- Subjects
COMPUTED tomography; KIDNEY tumors; SENSORY perception; UROLOGY; THREE-dimensional imaging; SURGICAL robots; PATIENT selection; PREOPERATIVE period; NEPHRECTOMY
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2019, Vol 29, Issue 2, p233
- ISSN
1092-6429
- Publication type
journal article
- DOI
10.1089/lap.2018.0486