title: Computer aided surgery for percutaneous nephrolithotomy: Clinical requirement analysis and system design.
abstract: Percutaneous nephrolithotomy (PCNL) for the treatment of renal stones and other related renal diseases has proved its efficacy and has stood the test of time compared with open surgical methods and extracorporeal shock wave lithotripsy. However, access to the collecting system of the kidney is not easy because the available intra-operative image modalities only provide a two dimensional view of the surgical scenario. With this lack of visual information, several punctures are often necessary which, increases the risk of renal bleeding, splanchnic, vascular or pulmonary injury, or damage to the collecting system which sometimes makes the continuation of the procedure impossible. In order to address this problem, this paper proposes a workflow for introduction of a stereotactic needle guidance system for PCNL procedures. An analysis of the imposed clinical requirements, and a instrument guidance approach to provide the physician with a more intuitive planning and visual guidance to access the collecting system of the kidney are presented.
authors.affiliation: Institute for Surgical Technology & Biomechanics, Bern University, Bern, Switzerland. thiago.oliveira@istb.unibe.ch
authors.forename: Thiago
authors.initials: T
authors.lastname: Oliveira-Santos
authors.forename: Matthias
authors.initials: M
authors.lastname: Peterhans
authors.forename: Beat
authors.initials: B
authors.lastname: Roth
authors.forename: Mauricio
authors.initials: M
authors.lastname: Reyes
authors.forename: Lutz-Peter
authors.initials: LP
authors.lastname: Nolte
authors.forename: George
authors.initials: G
authors.lastname: Thalmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
mesh_terms: D004867:Equipment Design; D057918:Fiducial Markers; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008953:Models, Anatomic; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed