title: Kidney displacement simulator for retroperitoneal laparoscopic nephrectomy.
abstract: 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.
authors.affiliation: Division of Urology, Nishinomiya Municipal Central Hospital, Hayashida-cho, 8-24 Nishinomiya, Hyoga 663-8014, Japan. htakiuchi@hotmail.com
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Takiuchi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mori
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shima
authors.forename: Masao
authors.initials: M
authors.lastname: Tanooka
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Hirayama
authors.forename: Norio
authors.initials: N
authors.lastname: Nakao
mesh_terms: 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