3D Access Planning for PCNL Needle Trajectory Accuracy
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Solution Overview
Problem
Minimally-invasive procedures like PCNL for kidney stone removal face challenges in accurately accessing the targeted site due to limited visibility and uncertainty in patient anatomy, leading to increased risks of collateral injury and repeated attempts.
Innovation Solution
A computer-based system processes patient-specific radiographic images to generate a three-dimensional representation, allowing users to identify and simulate access plans, calculate needle trajectories, and provide patient templates for precise needle insertion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If minimally-invasive procedures like PCNL are used to remove kidney stones, then patient recovery is improved and surgical trauma is reduced, but the physician's view of the treatment site is limited making it difficult to gain sufficient access to the targeted site
Solution Approach 1:
The system performs preliminary 3D reconstruction of patient anatomy from CT scans and pre-plans access routes before the actual surgery. This allows the physician to visualize and plan the optimal needle trajectory in advance, making the actual minimally-invasive procedure safer and more effective.
Solution Approach 2:
The system transforms 2D CT scan images into 3D visual representations of the kidney and surrounding anatomy. This dimensional enhancement provides the physician with comprehensive spatial understanding of the treatment site, enabling accurate needle placement while maintaining minimally-invasive benefits.
2Reliability
If repeated attempts are made to access the kidney stone without sufficient anatomical knowledge, then the chance of reaching the target may increase, but the risk of collateral injury to blood vessels, surrounding tissue, and neighboring organs increases
Solution Approach 1:
The system identifies and marks critical anatomical structures such as blood vessels and neighboring organs in the 3D reconstruction before the procedure. This preliminary identification allows the physician to plan access routes that avoid these critical structures, ensuring high success rate without repeated attempts that could cause injury.
Solution Approach 2:
The system provides real-time or pre-procedure feedback about the planned needle trajectory relative to critical structures. This feedback mechanism allows the physician to adjust the access plan before implementation, preventing collateral injury while ensuring reliable access to the kidney stone.
3Loss of information
If images like CT scans are obtained weeks or months before the PCNL procedure for reference, then anatomical information is available for planning, but the stone may have grown in size and/or changed position during the interim adding uncertainty
Solution Approach 1:
The system performs 3D reconstruction and access planning using the most recent CT scan images available, ideally obtained close to the procedure date. This minimizes the time gap between imaging and surgery, reducing the likelihood of stone movement or growth while maintaining comprehensive anatomical information.
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).