DVPV系统三维影像及虚拟现实导航在泌尿外科复杂手术的应用  

The application of dvpv 3d image virtual-reality navigation technology in complex urological operations

作　　者：温星桥[1] 祝炜安 王喻[1] 李腾成[1] 赖文杰 冷区 韩跃辅[3] 刘立林 腾东东 高新[1] Wen Xingqiao;Zhu Weian;Wang Yu;Li Tengcheng;Lai Wenjie;Leng Qu;Han Yuefu;Liu Lilin;Teng Dong;Gao Xin(Department of Urology,the Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China;Department of Urology,Zhu Jiang Hospital of Southern Medical University,Guangzhou 510282,China;Department of Urology,Yuebei Hospital,Shaoguan,512026,China;School of Electronics and Information Technology,Sun Yat-sen University,Guangzhou 510006,China;School of Physics,Sun Yat-sen University,Guangzhou 510275,China)

机构地区：[1]中山大学附属第三医院泌尿外科,广州510630 [2]南方医科大学珠江医院泌尿外科,广州510282 [3]粤北人民医院泌尿外科,韶关512026 [4]中山大学电子与信息工程学院,广州510006 [5]中山大学物理学院,广州510275

出　　处：《中华腔镜泌尿外科杂志（电子版）》2020年第2期91-95,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金面上项目(81874095)。

摘　　要：目的探讨DVPV数字化手术辅助影像导航技术在泌尿外科复杂手术中的应用价值。方法应用DVPV系统的三维可视化数字重建、虚拟现实应用、全息医疗专业影像平台,在普通CT或MRI数据的基础上进行三维图像重建,术前制定最优的手术方案,术中通过虚拟现实眼镜观看病灶影像并为手术操作进行导航。记录手术操作时间、疗效与围手术期并发症。结果 7例手术均顺利完成。3例肾血管平滑肌瘤(2例为较大体积,1例为肾门肿瘤)被完整切除,患侧肾脏均被保留。无损伤肾门血管和肾盂,平均出血量30 ml,平均手术时间105 min。在肾结石病例中,术中影像导航下避开肾脏重要血管,切开肾皮质的薄弱处取净鹿角型结石,手术时间120 min,出血量约50 ml。大体积中叶前列腺癌用腹腔镜技术完成根治术,出血量约75 ml。前列腺巨大囊性肿物行经直肠穿刺抽液+肿物活检术。肾上腺肿瘤用腹腔镜切除。全部患者平均住院日4.5 d,术中术后无并发症,恢复良好。结论 DVPV数字化手术影像导航系统有助于术前疾病评估,明确病变位置,术中虚拟现实影像导航,可提高医师操作的精准性,降低手术出血量、操作难度与风险,缩短手术时间,让患者获益。Objective To investigate the clinical significance of DVPV digital image virtual-reality navigation technology in complex urological operations. Methods DVPV system technology consists of three-dimensional(3D) visualization digital reconstruction, virtual reality application, 3d print and holographic medical professional image platform. The 3D digital images were reconstructed from traditional CT or MRI films. The glasses-free 3D and virtual reality technology were used to make the optimal surgical plan before operation and to present the images navigation during surgery. The operating time, efficacy, and complications of the cases were recorded. Results All the 7 cases had achieved successful operations. The three cases of renal angiomyolipomas(2 were large volume, 1 in renal hilum) were dissected completely with preserving the kidney, the blood vessels and the renal collecting system. The average blood loss was 30 ml, average operating time 105 min. The renal calculus was cleared by incising the thin area of the renal cortex with an operating time 120 min and blood loss 50 ml. Laparoscopic radical prostatectomy was performed in the prostate cancer patient with a large median lobe with blood loss 75 ml. Transrectal puncture and mass biopsy were performed in the large prostatic cyst patients. The adrenal gland tumor was dissected under a single-port laparoscopy operation. Average post-operative hospital time was 4.5 d in all patients. No complications were recorded. Conclusions The DVPV 3D image virtual-reality navigation technology provides helpful assistant in pre-operative disease evaluation and tumor location. The virtual-reality navigation during operating help to improve the surgical precision and reduce the blood loss, operating difficulties and risks, which providing benefits to the patients.

关 键 词：三维重建 虚拟现实 影像导航 DVPV技术 

分 类 号：R699[医药卫生—泌尿科学]