Mozer Pierre, Conort Pierre, Leroy Antoine, Baumann Michael, Payan Yohan, Troccaz Jocelyne, Chartier-Kastler Emmanuel, Richard François
Service d'Urologie, Groupe Hospitalier Pitié-Salpétrière, Paris, France.
J Endourol. 2007 May;21(5):460-5. doi: 10.1089/end.2006.0168.
Percutaneous renal access in the context of percutaneous nephrolithotomy (PCNL) is a difficult technique, requiring rapid and precise access to a particular calix. We present a computerized system designed to improve percutaneous renal access by projecting the ultrasound puncture tract onto fluoroscopic images.
The system consists of a computer and a localizer allowing spatial localization of the position of the various instruments. Without any human intervention, the ultrasound nephrostomy tract is superimposed in real time onto fluoroscopic images acquired in various views.
We tested our approach by laboratory experiments on a phantom. Also, after approval by our institution's Ethics Committee, we validated this technique in the operating room during PCNL in one patient.
Our system is reliable, and the absence of image-processing procedures makes it robust. We have initiated a prospective study to validate this technique both for PCNL specialists and as a learning tool.
经皮肾镜取石术（PCNL）中的经皮肾穿刺是一项困难的技术，需要快速、精确地穿刺到特定的肾盏。我们展示了一种计算机化系统，该系统通过将超声穿刺路径投影到荧光透视图像上，旨在改善经皮肾穿刺。
该系统由一台计算机和一个定位器组成，可对各种器械的位置进行空间定位。无需任何人工干预，超声肾造瘘路径可实时叠加到从不同视角获取的荧光透视图像上。
我们通过在模型上进行实验室实验来测试我们的方法。此外，在获得我们机构伦理委员会的批准后，我们在一名患者的PCNL手术过程中在手术室对该技术进行了验证。
我们的系统可靠，并且由于没有图像处理程序，使其更加稳健。我们已启动一项前瞻性研究，以验证该技术对PCNL专家以及作为一种学习工具的有效性。
