Department of Urology, University of California, Irvine, Orange CA.
Department of Urology, University of California, Irvine, Orange CA.
Urology. 2021 Jul;153:192-198. doi: 10.1016/j.urology.2020.12.046. Epub 2021 Feb 6.
To evaluate the efficacy of interactive virtual reality (iVR) in providing a three-dimensional (3D) experience with the donor's anatomy for surgeons and patients, we present a retrospective, case-controlled study assessing the impact of iVR renal models prior to LDN on both surgical outcomes and patients' understanding of the procedure.
Twenty patients undergoing LDN were prospectively recruited; their contrast-enhanced CT scans were transformed into iVR models. An iVR platform allowed the surgeons to rotate and deconstruct the renal anatomy; patients could also view their anatomy as the procedure was explained to them. Questionnaires assessed surgeons' understanding of renal anatomy after CT alone and after CT+iVR. Surgeons also commented on whether iVR impacted their preoperative plan. Patients assessed their anatomical understanding and anxiety level before and after iVR. Surgical outcomes for the iVR cohort were compared to a retrospectively matched, non-iVR cohort of LDN patients.
Surgeons altered their preoperative plan in 18 of 20 LDNs after viewing iVR models. Patients reported better understanding of their anatomy (5/5) and noted decreased preoperative anxiety (5/5) after viewing iVR. When compared to the non-iVR group, the iVR group had a 25% reduction in median operative time (P < .001). In terms of surgical outcomes, patients in the iVR group had a 40% lower median relative change in postoperative creatinine (P < .001).
Preoperative viewing of iVR models altered the operative approach, decreased the operative time, and improved donor patient outcomes. iVR models also reduced patients' preoperative anxiety.
评估交互式虚拟现实(iVR)在为外科医生和患者提供供体解剖结构的三维(3D)体验方面的疗效,我们进行了一项回顾性、病例对照研究,评估了 iVR 肾脏模型在 LDN 前对手术结果和患者对手术过程的理解的影响。
前瞻性招募了 20 名接受 LDN 的患者;对他们的增强 CT 扫描进行转化,生成 iVR 模型。iVR 平台允许外科医生旋转和分解肾脏解剖结构;患者也可以在向他们解释手术过程时查看自己的解剖结构。问卷调查评估了外科医生在单独使用 CT 和使用 CT+iVR 后对肾脏解剖结构的理解。外科医生还对 iVR 是否影响其术前计划发表了意见。患者在使用 iVR 前后评估了他们的解剖学理解和焦虑程度。比较了 iVR 组和回顾性匹配的非 iVR 组 LDN 患者的手术结果。
在 20 例 LDN 中,18 例外科医生在查看 iVR 模型后改变了术前计划。患者报告说,在观看 iVR 后,他们对自己的解剖结构有了更好的理解(5/5),并注意到术前焦虑减轻(5/5)。与非 iVR 组相比,iVR 组的中位手术时间缩短了 25%(P <.001)。就手术结果而言,iVR 组患者术后肌酐的中位数相对变化降低了 40%(P <.001)。
术前观看 iVR 模型改变了手术方法,缩短了手术时间,改善了供体患者的结局。iVR 模型还降低了患者的术前焦虑。