The advantage of a ureteroscopic navigation system with magnetic tracking in comparison with simulated fluoroscopy in a phantom study
The advantage of a ureteroscopic navigation system with magnetic tracking in comparison with simulated fluoroscopy in a phantom study
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在体模研究中，具有磁跟踪功能的输尿管镜导航系统与模拟荧光镜检查相比的优势
DOI：
10.1089/end.2015.0054
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Naito S.
中科院分区：
文献类型：
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作者：
Yoshida K;Yokomizo A;Matsuda T;Hamasaki T;Kondo Y;Yamaguchi K;Kanayama HO;Wakumoto Y;Horie S;Naito S.
目的：评估我们的输尿管镜实时导航系统是否有可能减少辐射暴露和提高性能的输尿管镜手术在不同年龄和经验levels.Materials的外科医生：我们的新型输尿管镜导航系统使用磁跟踪设备检测输尿管镜的位置，并显示在一个三维图像。我们从五个机构招募了31名泌尿科医生来执行两项任务。任务1包括在体模杯上找到三个内部标记。任务2包括通过输尿管镜检查识别所有肾盏。在这两项任务中，参与者首先使用模拟透视，然后使用我们的导航系统。结果：两种任务的识别准确率（AR）、完成任务所需时间（T）、移位长度（ML）和暴露于模拟透视的时间均显著优于无导航系统的情况（任务1：模拟透视vs.导航：AR 87.1%vs98.9%，P =0.003; T 355 vs 191 s，P<0.0001; ML 4627 mm vs2701 mm，P<0.0001。任务2：AR 88.2%vs96.7%，P =0.011; T 394 vs333 s，P=0.027; ML 5966 mm vs5299 mm，P=0.0006）。在这两项任务中，参与者使用模拟透视的时间约占总任务时间的20%。结论：与使用透视引导相比，我们的导航系统仍在开发中，可以帮助各级外科医生实现更好的输尿管镜操作性能。它也有可能减少荧光透视期间的辐射暴露。
Purpose:To assess whether our ureteroscopic real-time navigation system has the possibility to reduce radiation exposure and improve performance of ureteroscopic maneuvers in surgeons of various ages and experience levels.Materials and Methods:Our novel ureteroscopic navigation system used a magnetic tracking device to detect the position of the ureteroscope and display it on a three-dimensional image. We recruited 31 urologists from five institutions to perform two tasks. Task 1 consisted of finding three internal markings on the phantom calices. Task 2 consisted of identifying all calices by ureteroscopy. In both tasks, participants performed with simulated fluoroscopy first, followed by our navigation system. Accuracy rates (AR) for identification, required time (T) for completing the task, migration length (ML), and time exposed to simulated fluoroscopy were recorded.Results:The AR, T, and ML for both tasks were significantly better with the navigation system than without it (Task 1 with simulated fluoroscopyvswith navigation: AR 87.1 %vs98.9%,P=0.003; T 355 svs191 s,P<0.0001; ML 4627 mmvs2701 mm,P<0.0001. Task 2: AR 88.2%vs96.7%,P=0.011; T 394 svs333 s,P=0.027; ML 5966 mmvs5299 mm,P=0.0006). In both tasks, the participants used the simulated fluoroscopy about 20% of the total task time.Conclusions:Our navigation system, while still under development, could help surgeons of all levels to achieve better performances for ureteroscopic maneuvers compared with using fluoroscopic guidance. It also has the potential to reduce radiation exposure during fluoroscopy.