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

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。

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

ObjectiveTo investigate the clinical significance of DVPV digital image virtual-reality navigation technology in complex urological operations. MethodsDVPV 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. ResultsAll 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. ConclusionsThe 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.