Selcuk University, School of Medicine, Department of Urology, Konya, Turkey.
Konya Teknokent, AE Kod Teknolojisi, Konya, Turkey.
Med Hypotheses. 2019 Mar;124:101-104. doi: 10.1016/j.mehy.2019.02.007. Epub 2019 Feb 2.
Urinary stone disease has an increasing prevalence across the globe, and endoscopic treatment modalities have replaced open surgery. Percutaneous nephrolithotomy (PCNL) is a successful, safe and reliable minimally invasive method in the treatment of renal stones, especially big (≥2 cm) or complex ones. Gaining access is the most critical step of this procedure, which can affect the rest of the operation. Although previously described techniques, eye of the needle and triangulation techniques, are being used for gaining access, urologists (especially novice ones) can still have problems during this step. Some navigation concepts have been developed in order to make the access safer, easier and more successful, however, none of them has been incorporated in daily routine practice till now because of either complicated techniques or requirement of sophisticated equipment. Our hypothesis is that the access point, direction angle and access angle in order to touch a stone during PCNL can be calculated by the data obtained from the computed tomography images with the help of mathematical formulations, namely the theorem of the cosine.
尿路结石疾病在全球范围内的患病率不断增加，内镜治疗方法已经取代了开放性手术。经皮肾镜碎石术（PCNL）是治疗肾结石，特别是大（≥2cm）或复杂肾结石的一种成功、安全且可靠的微创方法。进入是该手术中最关键的一步，它会影响到手术的其余部分。尽管之前已经描述了一些进入的技术，如针眼和三角技术，但泌尿科医生（尤其是新手）在这一步仍然可能会遇到问题。为了使进入更安全、更容易和更成功，已经开发了一些导航概念，但到目前为止，由于技术复杂或需要复杂的设备，还没有一种方法被纳入日常实践中。我们的假设是，在 PCNL 过程中，可以通过借助数学公式（即余弦定理），利用从 CT 图像中获得的数据来计算进入点、方向角和进入角度，以触及结石。
