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Intrarenal arteries. Green line shows proper access path with minimal injury to renal arteries. Red lines are improper access path which crosses medium size arteries
Source publication
To find the variables that affect the proper access to desired calix in ultrasonography-guided percutaneous nephrolithotomy even by a newly trained endourologist. A total of consecutive 50 patients who were scheduled for PCNL between October 2018 and December 2018 in Shahid Labbafinejad hospital were enrolled in our study. After cystoscopy and uret...
Context in source publication
Context 1
... important step in PCNL is proper access to pelvicalyceal system. The best access is achieved by passing the needle through the tip of papilla to the targeted calyx, in such a way that its trajectory is along the axis of infundibulum and the guide wire could be passed to renal pelvis and/or ureter [2,11] (Fig. 1). By gaining proper access through the tip of papilla, risk of injury to medium size arteries and probability of pseudoaneurysm or arteriovenous fistula ...Similar publications
Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard first-line treatment for renal stones. It a successful, less invasive surgery (> 90%) but with high complication rate (> 10%). The study aims to see the outcome of PCNL in patients with renal stone who were treated. Materials and Methods: A retrospective study which included all...
Citations
... Ultrasound, recognized for its safety and convenience, has been extensively employed in PCN needle guidance. However, recent studies on ultrasound-guided PCN have shown that the single-puncture success rate can range from 34.3% to 91.2% due to its limited visualization details [17][18][19][20]. ...
Percutaneous nephrostomy (PCN) is a commonly used procedure for kidney surgeries. However, difficulties persist in precisely locating the PCN needle tip during its insertion into the kidney. Challenges for PCN needle guidance exist in two aspects: 1) Accurate tissue recognition, and 2) Renal blood vessel detection. In this study, we demonstrated an endoscopic optical coherence tomography (OCT) system for PCN needle guidance. Human kidney samples are utilized in the experiments. Different renal tissues including: 1) cortex, 2) medulla, 3) calyx, 4) fat, and 5) pelvis can be clearly distinguished based on their OCT imaging features. We conduct kidney perfusion experiments to mimic the renal blood flow. Our system can efficiently detect the blood flow in front of PCN needle using Doppler OCT function. To improve surgical guidance efficiency and alleviate the workload of radiologists, we employ convolutional neural network (CNN) methods to automate the procedure. Three CNN models including ResNet50, InceptionV3, and Xception were applied for tissue classification. All of them demonstrate promising prediction results, with InceptionV3 achieving the highest recognition accuracy of 99.6%. For automatic blood vessel detection, nnU-net was applied, and it exhibited intersection over unions (IoU) values of 0.8917 for blood vessel and 0.9916 for background.
