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Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance

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Abstract

Context

Large and complex renal stones are usually treated with percutaneous nephrolithotomy (PCNL). One of the crucial steps in this procedure is the access to the collecting system with the percutaneous puncture and this maneuver leads to a risk of vascular and neighboring organs’ injury. In the last years, the application of virtual image-guided surgery has gained wide diffusion even in this specific field.

Objectives

To provide a short overview of the most recent evidence on current applications of virtual imaging guidance for PCNL.

Evidence acquisition

A non-systematic review of the literature was performed. Medline, PubMed, the Cochrane Database and Embase were screened for studies regarding the use virtual imaging guidance for PCNL.

Evidence synthesis

3D virtual navigation technology for PCNL was first used in urology with the purpose of surgical training and surgical planning; subsequently, the field of surgical navigation with different modalities (from cognitive to augmented reality or mixed reality) had been explored. Finally, anecdotal preliminary experiences explored the potential application of artificial intelligence guidance for percutaneous puncture.

Conclusion

Nowadays, many experiences proved the potential benefit of virtual guidance for surgical simulation and training. Focusing on surgery, this tool revealed to be useful both for surgical planning, allowed to achieve a better surgical performance, and for surgical navigation by using augmented reality and mixed reality systems aimed to assist the surgeon in real time during the intervention.

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Authors and Affiliations

  1. Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142, km 3,95, 10060, Candiolo, Turin, Italy

    E. Checcucci

  2. Uro-Technology and SoMe Working Group of the Young Academic Urologists (YAU) Working Party of the European Association of Urology (EAU), Arnhem, The Netherlands

    E. Checcucci

  3. Department of Oncology, Division of Urology, University of Turin, Turin, Italy

    E. Checcucci, D. Amparore, G. Volpi, F. Piramide, S. De Cillis, A. Piana, P. Alessio, P. Verri, S. Piscitello, B. Carbonaro, J. Meziere, D. Zamengo, S. De Luca, M. Manfredi, C. Fiori & F. Porpiglia

  4. Department of Urology, University Hospital of Patras, Patras, Greece

    A. Tsaturyan & E. Liatsikos

  5. USC Institute of Urology, University of Southern California, Los Angeles, CA, USA

    G. Cacciamani

  6. Department of Urology, La Paz University Hospital, Madrid, Spain

    Juan Gomez Rivas

  7. Department of Urology, Medical University of Vienna, Vienna, Austria

    E. Liatsikos

Authors
  1. E. Checcucci
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  2. D. Amparore
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Contributions

Protocol/project development: EC, DA, GC, JGR; data collection or management: SDC, AP, AT; data analysis: SP, DZ, JM, BC, AP; manuscript writing/editing: EC, GV; supervision: CF, MM, SDL, EL, FP.

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Correspondence to E. Checcucci.

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Checcucci, E., Amparore, D., Volpi, G. et al. Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance. World J Urol 40, 639–650 (2022). https://doi.org/10.1007/s00345-021-03820-4

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  • DOI: https://doi.org/10.1007/s00345-021-03820-4

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