切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 91 -95. doi: 10.3877/cma.j.issn.1674-3253.2020.02.004

所属专题: 文献

临床研究

DVPV系统三维影像及虚拟现实导航在泌尿外科复杂手术的应用
温星桥1,(), 祝炜安1, 王喻1, 李腾成1, 赖文杰1, 冷区2, 韩跃辅3, 刘立林4, 腾东东5, 高新1   
  1. 1. 510630 广州,中山大学附属第三医院泌尿外科
    2. 510282 广州,南方医科大学珠江医院泌尿外科
    3. 512026 韶关,粤北人民医院泌尿外科
    4. 510006 广州,中山大学电子与信息工程学院
    5. 510275 广州,中山大学物理学院
  • 收稿日期:2019-12-25 出版日期:2020-04-01
  • 通信作者: 温星桥
  • 基金资助:
    国家自然科学基金面上项目(81874095)

The application of dvpv 3d image virtual-reality navigation technology in complex urological operations

Xingqiao Wen1,(), Weian Zhu1, Yu Wang1, Tengcheng Li1, Wenjie Lai1, Qu Leng2, Yuefu Han3, Lilin Liu4, Dong Teng5, Xin Gao1   

  1. 1. Department of Urology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China
    2. Department of Urology, Zhu Jiang Hospital of Southern Medical University, Guangzhou 510282, China
    3. Department of Urology, Yuebei Hospital, Shaoguan, 512026, China
    4. School of Electronics and Information Technology, Sun Yat-sen University, Guangzhou 510006, China
    5. School of Physics, Sun Yat-sen University, Guangzhou 510275, China
  • Received:2019-12-25 Published:2020-04-01
  • Corresponding author: Xingqiao Wen
  • About author:
    Corresponding author: Wen Xingqiao, Email:
引用本文:

温星桥, 祝炜安, 王喻, 李腾成, 赖文杰, 冷区, 韩跃辅, 刘立林, 腾东东, 高新. DVPV系统三维影像及虚拟现实导航在泌尿外科复杂手术的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(02): 91-95.

Xingqiao Wen, Weian Zhu, Yu Wang, Tengcheng Li, Wenjie Lai, Qu Leng, Yuefu Han, Lilin Liu, Dong Teng, Xin Gao. The application of dvpv 3d image virtual-reality navigation technology in complex urological operations[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(02): 91-95.

目的

探讨DVPV数字化手术辅助影像导航技术在泌尿外科复杂手术中的应用价值。

方法

应用DVPV系统的三维可视化数字重建、虚拟现实应用、全息医疗专业影像平台,在普通CT或MRI数据的基础上进行三维图像重建,术前制定最优的手术方案,术中通过虚拟现实眼镜观看病灶影像并为手术操作进行导航。记录手术操作时间、疗效与围手术期并发症。

结果

7例手术均顺利完成。3例肾血管平滑肌瘤(2例为较大体积,1例为肾门肿瘤)被完整切除,患侧肾脏均被保留。无损伤肾门血管和肾盂,平均出血量30 ml,平均手术时间105 min。在肾结石病例中,术中影像导航下避开肾脏重要血管,切开肾皮质的薄弱处取净鹿角型结石,手术时间120 min,出血量约50 ml。大体积中叶前列腺癌用腹腔镜技术完成根治术,出血量约75 ml。前列腺巨大囊性肿物行经直肠穿刺抽液+肿物活检术。肾上腺肿瘤用腹腔镜切除。全部患者平均住院日4.5 d,术中术后无并发症,恢复良好。

结论

DVPV数字化手术影像导航系统有助于术前疾病评估,明确病变位置,术中虚拟现实影像导航,可提高医师操作的精准性,降低手术出血量、操作难度与风险,缩短手术时间,让患者获益。

Objective

To investigate the clinical significance of DVPV digital image virtual-reality navigation technology in complex urological operations.

Methods

DVPV system technology consists of three-dimensional(3D) visualization digital reconstruction, virtual reality application, 3 d print and holographic medical professional image platform. The 3D digital images were reconstructed from traditional CT or MRI films. The glasses-free 3D and virtual reality technology were used to make the optimal surgical plan before operation and to present the images navigation during surgery. The operating time, efficacy, and complications of the cases were recorded.

Results

All the 7 cases had achieved successful operations. The three cases of renal angiomyolipomas (2 were large volume, 1 in renal hilum) were dissected completely with preserving the kidney, the blood vessels and the renal collecting system. The average blood loss was 30 ml, average operating time 105 min. The renal calculus was cleared by incising the thin area of the renal cortex with an operating time 120 min and blood loss 50 ml. Laparoscopic radical prostatectomy was performed in the prostate cancer patient with a large median lobe with blood loss 75 ml. Transrectal puncture and mass biopsy were performed in the large prostatic cyst patients. The adrenal gland tumor was dissected under a single-port laparoscopy operation. Average post-operative hospital time was 4.5 d in all patients. No complications were recorded.

Conclusions

The DVPV 3D image virtual-reality navigation technology provides helpful assistant in pre-operative disease evaluation and tumor location. The virtual-reality navigation during operating help to improve the surgical precision and reduce the blood loss, operating difficulties and risks, which providing benefits to the patients.

图1 手术中实时DVPV影像导航及相关场景
图2 DVPV系统协助显示左肾脏肿瘤位置,引导切除并保留患肾
图3 DVPV系统三维影像显示前列腺肿瘤、肾门肿瘤的位置和毗邻结构
图4 应用DVPV系统术中影像导航,切开左肾取出铸型结石(黄色为肾结石)
[1]
Bertolo R, Autorino R, Fiori C, et al. Expanding the indications of robotic partial nephrectomy for highly complex renal tumors: urologists' perception of the impact of hyperaccuracy three-dimensional reconstruction[J]. J Laparoendosc Adv Surg Tech A, 2019, 29(2): 233-239.
[2]
王东文,原小斌. 走进数字泌尿新时代:数字医学技术在精准泌尿外科的应用[J/CD]. 中华腔镜外科杂志(电子版), 2019, 12(2): 70-74.
[3]
van Oosterom M, van der Poel H, Navab N, et al. Computer-assisted surgery: Virtual-and augmented-reality displays for navigation during urological interventions[J]. Current Opin Urol, 2017, 28(2): 1-3.
[4]
张童鑫,艾龙龙,张玉江, 等. 三维可视化技术与二维影像比较辅助肝切除术临床效果的Meta分析[J]. 中国循证医学杂志, 2018, 18(8): 850-857.
[5]
Checcucci E, Amparore D, Pecoraro A, et al. 3D mixed reality holograms for preoperative surgical planning of nephron-sparing surgery: evaluation of surgeons' perception[J]. Minerva Urol Nefrol, 2019, [Online ahead of print].
[6]
卢家俊,施云涛,史向军, 等. 三维可视化技术在腹膜后肿瘤切除术中应用研究[J]. 中国实用外科杂志, 2019, 39(9): 959-963.
[7]
Hamacher A, Kim SJ, Cho ST, et al. Application of virtual, augmented, and mixed reality to urology[J]. Int Neurourol J, 2016, 20(3): 172-181.
[8]
Wang Z, Qi L, Yuan P, et al. Application of three-dimensional visualization technology in laparoscopic partial nephrectomy of renal tumor: a comparative study[J]. J Laparoendosc Adv Surg Tech A, 2017, 27(5): 516-523.
[9]
Wang D, Zhang B, Yuan X, et al. Preoperative planning and real-time assisted navigation by three-dimensional individual digital model in partial nephrectomy with three-dimensional laparoscopic system[J]. Int J Comput Assist Radiol Surg 2015, 10(9): 1461-1468.
[10]
王学智,罗建华,刘心梅. CT三维重建在鹿角形结石手术治疗中的应用[J]. 当代医学, 2018, 24(23): 148-149.
[11]
Porpiglia F, Fiori C, Checcucci E, et al. Augmented reality robot-assisted radical prostatectomy: preliminary experience[J]. Urol, 2018, 115: 184.
[12]
Porpiglia F, Checcucci E, Amparore D, et al. Three-dimensional elastic augmented-reality robot-assisted radical prostatectomy using hyperaccuracy three-dimensional reconstruction technology: a step further in the identification of capsular involvement[J]. Eur Urol, 2019, 76(4): 505-514.
[13]
王田苗,张晓会,张学斌, 等. 腹腔镜增强现实导航的研究进展综述[J]. 机器人, 2019, 41(1): 124-136.
[14]
Bernhardt S, Nicolau, Stephane A, et al. The status of augmented reality in laparoscopic surgery as of 2016[J]. Medical Image Analysis, 2017, 37: 66-90.
[1] 唐浩, 梁平, 徐小江, 曾凯, 文拨辉. 三维重建指导下腹腔镜右半肝加尾状叶切除治疗Bismuth Ⅲa型肝门部胆管癌的临床研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 688-692.
[2] 罗勇, 麦刚. 三维重建技术在腹腔镜肝尾状叶切除术中的效果[J]. 中华普外科手术学杂志(电子版), 2022, 16(06): 639-642.
[3] 余萍, 罗兵, 喻定刚. 基于三维重建引导下腹腔镜右半结肠切除术与传统手术的疗效及预后比较[J]. 中华普外科手术学杂志(电子版), 2022, 16(05): 502-505.
[4] 李三祥, 李佳, 刘俊峰, 吕东晨, 方晖东, 谭朝晖, 刘杰, 潘佐, 乔建坤. 基于CT影像的三维重建成像技术在腹腔镜大肾上腺肿瘤切除术中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 570-574.
[5] 胡博文, 戴英波. 泌尿外科机器人手术新趋势[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(04): 418-421.
[6] 周子健, 吴忠. CT在泌尿系结石诊疗中的应用进展[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(03): 299-302.
[7] 王祎, 王峻峰, 杨超, 晋云, 胡苹苹. 数字医学技术在肝脏分段及解剖性肝切除中的应用现状[J]. 中华肝脏外科手术学电子杂志, 2023, 12(01): 16-21.
[8] 马木提江·木尔提扎, 汪永新, 阿西木江·阿西尔, 姜彦文, 秦虎. 多模态三维影像融合技术在颅内功能区病变手术中的应用[J]. 中华神经创伤外科电子杂志, 2023, 09(05): 302-307.
[9] 王奎重, 王天助, 袁冶, 胡金娜, 杜嘉庚, 袁绍纪. 三维重建术前计划在经侧脑室后角穿刺脑室-腹腔分流术中的应用[J]. 中华神经创伤外科电子杂志, 2022, 08(06): 361-364.
[10] 姜佳慧, 毕鸿雁. 基于虚拟现实技术施经颅直流电刺激对脑卒中患者上肢功能影响的Meta分析[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(02): 75-83.
[11] 陆志峰, 周佳佳, 梁舒. 虚拟现实技术在治疗弱视中的临床应用研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 891-895.
[12] 李岩松, 李涛, 张元鸣飞, 李志鹏, 周谋望. 头戴式虚拟现实设备辅助全膝关节置换术后康复的初步研究[J]. 中华临床医师杂志(电子版), 2023, 17(06): 676-681.
[13] 黄爱茹, 付婧, 余茜. 多模块3D虚拟现实技术联合重复经颅磁刺激治疗卒中后认知功能障碍的效果[J]. 中华临床医师杂志(电子版), 2022, 16(11): 1089-1095.
[14] 索源, 曹伟, 杨书聪, 杨成, 周宇立, 郁慧杰. 沉浸式虚拟现实结合高仿真伤情化妆技术在创伤紧急医学救治培训中的应用效果评价[J]. 中华卫生应急电子杂志, 2023, 09(02): 85-89.
[15] 常飞飞, 曹迎春, 吴晓冰, 王晓涵. 基于虚拟现实技术任务导向性训练对脑卒中多病共存患者功能状态的影响[J]. 中华脑血管病杂志(电子版), 2023, 17(02): 124-129.
阅读次数
全文


摘要