Patient-Specific PCNL Access Planning From Radiographic Images
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Solution Overview
Problem
Minimally-invasive procedures like PCNL for kidney stone removal face challenges due to limited visibility of the treatment site, leading to potential collateral injury and increased risk of hemorrhage, infection, and fluid leakage, as existing systems lack patient-specific anatomical understanding and accurate access planning.
Innovation Solution
A computer-based system for generating patient-specific surgical access plans using radiographic images, allowing for three-dimensional representation and user input to identify features, calculate stone characteristics, and generate access plans, which can be printed as a template for precise needle insertion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If minimally-invasive procedures like PCNL are used for kidney stone removal, then patient recovery time is reduced and surgical trauma is minimized, but the physician has limited view of the treatment site leading to increased risk of collateral injury
Solution Approach 1:
The system performs preoperative planning and generates a patient-specific access plan before the actual PCNL procedure. The access plan includes the optimal needle insertion site, trajectory, and angle calculated based on patient-specific anatomical features extracted from radiographic images, allowing the physician to prepare and visualize the approach in advance, thereby reducing intraoperative risks while maintaining minimally-invasive benefits
Solution Approach 2:
The system introduces a computer-based planning system as an intermediary between the physician and the patient anatomy. This intermediary processes radiographic images, identifies anatomical features, calculates optimal access parameters, and generates visual guidance that bridges the information gap caused by limited direct visualization during minimally-invasive surgery
2Productivity
If repeated attempts at access are made to remove the stone, then the likelihood of successfully removing the stone increases, but the risk of collateral injury to blood vessels, surrounding tissue, and neighboring organs increases
Solution Approach 1:
The system calculates and determines the optimal access plan before the procedure begins, identifying the single best trajectory and insertion point based on patient-specific anatomy. This preliminary determination reduces the need for repeated blind attempts during surgery by providing the physician with pre-calculated optimal parameters
Solution Approach 2:
The system replaces the traditional mechanical trial-and-error approach of repeated physical attempts with a computer-based calculation and visualization system. The computer calculates optimal parameters and provides visual guidance, substituting iterative mechanical probing with intelligent computational planning
3Loss of information
If patient images like CT scans are obtained weeks or months before the PCNL procedure for reference, then the physician has anatomical reference data available, but the stone may have grown in size and/or changed position during the interim adding uncertainty
Solution Approach 1:
The system utilizes the most recent available radiographic images and recalculates the access plan based on current stone characteristics. By updating the stone size, position, and density parameters from the latest imaging data, the system adapts the access plan to reflect current anatomical conditions rather than relying on outdated measurements
4Reliability
If a computer-based system with three-dimensional representation and user input is used to generate access plans, then procedural accuracy and safety are improved, but device complexity increases
Solution Approach 1:
The system automatically performs image processing, anatomical feature identification, and access plan calculation without requiring complex manual interventions. The computer-based system serves itself by autonomously processing radiographic images and generating recommendations, reducing the operational complexity burden on the user while maintaining high reliability
Data Source
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AI summary
Computer systems and computer-implemented analysis methods may be used for assistance in planning and/or performing a medical procedure, such as percutaneous nephrolithotomy or percutaneous nephrolithotripsy. The method may include receiving one or more radiographic images of an anatomical structure of a patient, generating a display of the radiographic image(s), generating at least one request for user input to identify features of the anatomical structure, receiving user input identifying the features of the anatomical structure, identifying at least one access plan based on the received user input, and generating a display of the identified access plan(s) associated with the radiographic image(s). The method may include generating a patient template that indicates an insertion site according to the identified access plan(s).