Clinical Value of Mixed Reality-Assisted Puncture Navigation for Percutaneous Nephrolithotripsy

OBJECTIVE To evaluate the clinical value of mixed reality-assisted puncture navigation (MRAPN) in percutaneous nephrolithotripsy (PCNL).METHODS Two hundred patients undergoing PCN were enrolled, all of whom had kidney stones to be subjected to lithotripsy by PCNL and grouped according to surgical procedure into the MRAPN (n = 100) and non-mixed reality-assisted puncture (non-MRAPN) (n = 100) groups. CT data in DICOM format for all patients in the MRAPN group were imported into 3D reconstruction and mixed reality (MR) post-processing workstations, and holographic 3D visualization modelling. Comparing parameters such as the operative time (OT), puncture time (PT), number of attempts, and estimated blood loss (EBL), a Likert scale was used to assess the clinical value of MRAPN. The Cohen K coefficient (k) was employed to evaluate consistency among assessors; safety was assessed.RESULTS There were no significant differences in patient demographic indicators or preoperative general information between the MRAPN and non-MRAPN groups (P > .05). The clinical value of MRAPN was higher for subjective scores regarding surgical planning, intraoperative navigation, didactic guidance and physician-patient communication (all P < .001). The PT was significantly shorter in the MRAPN group (P < .001), with a shorter overall OT and lower EBL (P < .001). There were no significant differences in the overall comparison, length of hospital stay, or preoperative or postoperative creatinine (all P > .05).CONCLUSION MRAPN can safely and effectively improve the success of PCN, reduce complications, and decrease the PT, OT, and EBL.

Automated summary

This study evaluated the clinical value of mixed reality-assisted puncture navigation (MRAPN) in percutaneous nephrolithotripsy (PCNL). The results showed that MRAPN group had higher subjective scores in surgical planning, intraoperative navigation, didactic guidance, and physician-patient communication. The MRAPN group also had a shorter puncture time, overall operation time, and estimated blood loss.