Soria Federico, Delgado M Inmaculada, Sánchez Francisco M, Allona Antonio, Jiménez Cruz J Fernando, Morell Enrique, Usón Jesús
Department of Endoscopy-Endourology, Minimally Invasive Surgery Centre-Jesus Usón, Cáceres, Spain.
Urology. 2009 Mar;73(3):649-52; discussion 652-4. doi: 10.1016/j.urology.2008.09.063. Epub 2008 Dec 18.
To present, in an experimental study, an assessment of innovative digital fluoroscopy systems with three-dimensional (3D) reconstruction for use in endourologic applications.
The experiment was performed in a pig model. We used 5 pigs. An obstructive uropathy model was created in the right kidney to dilate the urinary tract for group 1. Group 2 consisted of the nondilated left kidney. After selecting the tract on the 3D image, the lower caliceal group was punctured in the 2 kidneys under fluoroscopic control, to assess the efficiency of the 3D reconstruction when selecting the renal calix to be punctured.
The 3D reconstruction system allowed us to obtain reconstruct the pelvis in three dimensions, isolated as the pelvis and renal parenchyma, as well as the adjacent bony relationships. In this study, the success rate was 100% for locating the selected renal calix.
With this 3D reconstruction system, we were able to obtain a series of images that allowed for the study of the volume of the kidney, perfectly determining its renal calix distribution in the operating room. This enabled us to determine the precise delineation of the target calix. We, therefore, consider this new urologic application of fluoroscopy very useful in surgical planning for antegrade access of the upper urinary tract.
