Zhai Jianpo, Zhang Yong, Wang Hai, Li Guizhong, Man Libo
Department of Urology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 102208, China.
TINAVI Medical Technologies Co., Ltd, Beijing, China.
World J Urol. 2025 Jan 20;43(1):81. doi: 10.1007/s00345-025-05450-6.
The objective of this study was to explore the feasibility of using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro.
A pig kidney with a segment of ureter was selected as the in vitro organ model. Iodine contrast agent was infused into the renal pelvis to dilate the renal pelvis and calyx to establish the in vitro hydronephrosis model. Fluoroscopic images were obtained using a 3D C-arm and transferred to the robotic workstation. Three-dimensional reconstructed images were generated and displayed on the monitor screen. The surgeon planned the optimal puncture trajectory on the workstation. After that, the robotic arm was instructed to move to the surgical field. The guiding cannula was placed onto the robotic arm and brought close to the skin. The needle was placed along the guiding cannula. An 18G needle was inserted manually. Finally, a second CBCT scan was performed to validate the needle's location.
Three hydronephrosis models were used in the study, and a total of seven target calyces were planned. six target calyces were successfully punctured in one attempt, with a single-puncture success rate of 87.5%.
A high single-puncture success rate is achieved using the TianJi Robot system for navigated needle positioning in the PCNL procedure in vitro, marking an innovative step forward in urological interventions.
本研究的目的是探讨在体外经皮肾镜取石术(PCNL)中使用天玑机器人系统进行导航穿刺针定位的可行性。
选取一段带有输尿管的猪肾作为体外器官模型。向肾盂内注入碘造影剂以扩张肾盂和肾盏,建立体外肾积水模型。使用三维C形臂获取透视图像并传输至机器人工作站。生成三维重建图像并显示在监视器屏幕上。外科医生在工作站上规划最佳穿刺路径。之后,指示机器人手臂移动至手术区域。将引导套管置于机器人手臂上并靠近皮肤。沿引导套管放置穿刺针。手动插入一根18G穿刺针。最后,进行第二次CBCT扫描以验证穿刺针的位置。
本研究使用了三个肾积水模型,共规划了七个目标肾盏。六个目标肾盏一次穿刺成功,单次穿刺成功率为87.5%。
在体外PCNL手术中使用天玑机器人系统进行导航穿刺针定位可实现较高的单次穿刺成功率,这标志着泌尿外科干预迈出了创新性的一步。