Kidney displacement simulator for retroperitoneal laparoscopic nephrectomy.
OBJECTIVE
We evaluated the efficacy of a renal displacement simulator originally developed at our department for retroperitoneal laparoscopic nephrectomy.


METHODS
A total of 12 patients with a malignant localized renal (7) or ureteral (5) neoplasm underwent multidetector row computerized tomography. Imaging data were sent to a dedicated work station to create volume rendering and virtual laparoscopic images of the kidney, which was displaced ventral using a retroperitoneal balloon. These findings were compared with video images obtained during laparoscopy surgery.


RESULTS
The kidney displacement simulator depicted all renal arteries (100% sensitivity) and 13 of 14 renal veins (93% sensitivity). Hilar anatomy, including the tumor, as well as major vessels and their relationships were visualized by the simulator in the laparoscopic views. The major vessel portions completely corresponded to those seen during surgery, and the left adrenal and gonadal veins were also synchronized quite well.


CONCLUSIONS
Our kidney displacement simulator was able to visualize the major vessel portions and branched small vessels, such as the adrenal and gonadal veins, prior to surgery. It is considered useful for providing guidance to surgeons and decreasing operative risks and possible complications.
Takiuchi
Hidekazu
H
Division of Urology, Nishinomiya Municipal Central Hospital, Hayashida-cho, 8-24 Nishinomiya, Hyoga 663-8014, Japan. htakiuchi@hotmail.com
Mori
Yoshinori
Y
Shima
Hiroki
H
Tanooka
Masao
M
Hirayama
Shin-Ichi
S
Nakao
Norio
N
D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D003198:Computer Simulation; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation* / Q000379:methods*; D012187:Retroperitoneal Space; D012680:Sensitivity and Specificity; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014741:Video Recording