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基于深度学习和混合现实的手术导航系统在经皮肾镜取石术中引导穿刺的应用价值:一项回顾性研究。

Application value of surgical navigation system based on deep learning and mixed reality for guiding puncture in percutaneous nephrolithotomy: a retrospective study.

机构信息

Department of Urology, Dongguan People's Hospital, No.78, Wandao Road, Wanjiang Street, Dongguan City, Guangdong, P. R. China.

出版信息

BMC Urol. 2024 Oct 21;24(1):230. doi: 10.1186/s12894-024-01618-1.

Abstract

BACKGROUND

This study was conducted to investigate the clinical value of a navigation system based on deep learning and mixed reality for the treatment of kidney stones with percutaneous nephrolithotomy (PNL), and to improve its theoretical basis for the treatment of kidney stones.

METHODS

The data of 136 patients with kidney stones from October 2021 to December 2023 were retrospectively analyzed. All patients underwent PNL, and were categorized into a control group (Group 1) and a surgical navigation group (Group 2) according to puncture positioning method. Preoperative computed tomography (CT) was performed in both groups. In group 1, procedures were performed under standard ultrasound guidance. PNL was performed with navigation system fused with ultrasound to guide percutaneous puncture in group 2. The baseline information and procedural characteristics of both groups were compared.

RESULTS

PNL was successfully performed in both groups. No significant difference was found in the baseline date between the two groups. In group 2, real-time ultrasound images could be accurately matched with CT images with the aid of navigation system. The success rate of single puncture, puncture time, and decrease in hemoglobin were significantly improved in group 2 compared to group 1. (p < 0.05).

CONCLUSIONS

The application of navigation system based on deep learning and mixed reality in PNL for kidney stones allows for real-time intraoperative navigation, with acceptable accuracy and safety. Most importantly, this technique is easily mastered, particularly by novice surgeons in the field of PNL.

摘要

背景

本研究旨在探讨基于深度学习和混合现实的导航系统在经皮肾镜取石术(PNL)治疗肾结石中的临床价值,为肾结石的治疗提供理论依据。

方法

回顾性分析 2021 年 10 月至 2023 年 12 月收治的 136 例肾结石患者的临床资料。所有患者均接受 PNL 治疗,根据穿刺定位方法分为对照组(第 1 组)和手术导航组(第 2 组)。两组患者术前均行 CT 检查。第 1 组采用标准超声引导下进行手术,第 2 组采用融合超声的导航系统辅助 PNL 进行经皮穿刺。比较两组患者的基线资料和手术特点。

结果

两组患者均成功完成 PNL。两组患者的基线资料比较,差异无统计学意义。第 2 组在导航系统的辅助下,实时超声图像可与 CT 图像准确匹配,单次穿刺成功率、穿刺时间和血红蛋白下降量均明显优于第 1 组(p<0.05)。

结论

基于深度学习和混合现实的导航系统在肾结石 PNL 中的应用,实现了术中实时导航,具有良好的准确性和安全性。该技术易于掌握,尤其适合 PNL 领域的新手术者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e86/11492472/60af5b2d25e4/12894_2024_1618_Fig1_HTML.jpg

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