Three-dimensional printing models of horseshoe kidney and duplicated pelvicalyceal collecting system for flexible ureteroscopy training: a pilot study

Sobrinho, Ulisses L G Pereira; Albero, José R P; Becalli, Marina L P; Sampaio, Francisco J.B.; Favorito, Luciano A.

doi:10.1590/s1677-5538.ibju.2021.99.10

Cited by 7 publications

(2 citation statements)

References 5 publications

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“…Three-dimensional printing technology has been applied in kidney surgery, including PN and flexible ureterorenoscopy, where knowledge of the intrarenal anatomy is critical for minimally invasive approaches. In addition, optimizing the surgical steps of the procedure by using these tools can improve perioperative and functional outcomes in cases with complex renal tumors ( 14 , 15 ).…”

Section: Discussionmentioning

confidence: 99%

The influence of 3D renal reconstruction on surgical planning for complex renal tumors: An interactive case-based survey

Azhar

2023

Int. braz j urol.

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Objectives: To evaluate the role of three-dimensional (3D) reconstruction in preoperative planning for complex renal tumors. Materials and Methods: A well-planned questionnaire was distributed among the attending urologists at an international meeting. The questionnaire inquired about demographic data, surgical experience, partial nephrectomy (PN) versus radical nephrectomy (RN), surgical approach, time of ischemia, probability of postoperative urine leakage and positive surgical margins after viewing computed tomography (CT) scans and their respective 3D models of six complex renal tumors. Following the CT scans, attendees were asked to view randomly selected reconstructions of the cases. Results: One hundred expert urologists participated in the study; 61% were aged between 40 and 60 years. Most of them (74%) were consultants. The overall likelihood of PN after viewing the 3D reconstructions significantly increased (7.1±2.7 vs. 8.0±2.2, p<0.001), the probability of conversion to RN significantly decreased (4.3±2.8 vs. 3.2±2.5, p<0.001), and the likelihood of urine leakage and positive surgical margins significantly decreased (p<0.001). Preference for the open approach significantly decreased (21.2% vs. 12.1%, p<0.001), while selective clamping techniques significantly increased (p<0.001). After viewing the 3D models, low expected warm ischemia time and estimated blood loss were significantly preferred by the respondents (p<0.001). Surgical decision change was significantly associated with performance or participation in more than 20 PNs or RNs annually [3.25 (1.98-5.22) and 2.87 (1.43-3.87), respectively]. Conclusions: 3D reconstruction models play a significant role in modifying surgeons' strategy and surgical planning for patients with renal tumors, especially for patients with stronger indications for a minimally invasive and/or nephron-sparing approach.

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Section: Discussionmentioning

confidence: 99%

The influence of 3D renal reconstruction on surgical planning for complex renal tumors: An interactive case-based survey

Azhar

2023

Int. braz j urol.

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Robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty for ureteropelvic junction obstruction in horseshoe kidney using KangDuo-Surgical-Robot-01 system

Fan

et al. 2023

Int. braz j urol.

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Purpose Horseshoe kidney (HSK) is the most common renal fusion anomaly, occurring in 0.25% of the population ( 1 ). It presents technical obstacles to pyeloplasty for ureteropelvic junction obstruction (UPJO) despite robotic assistance ( 2 , 3 ). KangDuo-Surgical-Robot-01 (KD-SR-01), an emerging robotic platform in China, has yielded satisfactory outcomes in pyeloplasty ( 4 , 5 ). We first describe our modified technique of robotic bilateral pyeloplasty for UPJO in HSK using KD-SR-01 system in the Lithotomy Trendelenburg position. Materials and Methods A 36-year-old man with HSK and bilateral UPJO suffered right flank pain due to renal calculi ( Figure-1 ). Repeated double-J stent insertion and ureteroscopy lithotripsy did not relieve his symptoms. A robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty was performed using KD-SR-01 system in the Lithotomy Trendelenburg position. Results Total operative time was 298 minutes with 50 ml estimated blood loss. There was no conversion to laparoscopic or open surgery. A follow-up of 14 months showed relieving symptoms and stable renal function. Cine magnetic resonance urography and computed tomography urography revealed improved hydronephrosis and good drainage. No intraoperative or postoperative complications occurred. Conclusions It is technically feasible to perform a KD-SR-01-assisted modified bilateral dismembered V-shaped flap pyeloplasty in the Lithotomy Trendelenburg position for HSK. This procedure achieves managing UPJO on both sides without redocking the system and provides a wider operative field. In addition, it may be associated with better ergonomics, better cosmetic outcomes, and less possibility of postoperative bowel adhesion. However, further investigation is still warranted to confirm its safety, efficacy, and advantages over traditional procedures.

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Urethral reconstruction and genitoplasty highlighted in International Brazilian Journal of Urology

Favorito¹

2021

Int. braz j urol.

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Three-dimensional printing models of horseshoe kidney and duplicated pelvicalyceal collecting system for flexible ureteroscopy training: a pilot study

Cited by 7 publications

References 5 publications

The influence of 3D renal reconstruction on surgical planning for complex renal tumors: An interactive case-based survey

The influence of 3D renal reconstruction on surgical planning for complex renal tumors: An interactive case-based survey

Robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty for ureteropelvic junction obstruction in horseshoe kidney using KangDuo-Surgical-Robot-01 system

Urethral reconstruction and genitoplasty highlighted in International Brazilian Journal of Urology

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