基于3D Slicer软件的三维重建技术在腹腔镜肾切除术处理肾血管中的应用  

Application of 3D reconstruction technology based on 3D Slicer software in renal vascular management of laparoscopic nephrectomy

作　　者：赵伟[1] 曹龙滨[1] 高辉[1] 李玉侨[1] 马征[1] 马云波[1] ZHAO Wei;CAO Longbin;GAO Hui;LI Yuqiao;MA Zheng;MA Yunbo(Department of Urology,Liaocheng People s Hospital,Liaocheng 252000,China)

机构地区：[1]山东省聊城市人民医院泌尿外科,山东聊城252000

出　　处：《现代泌尿外科杂志》2022年第5期404-407,共4页Journal of Modern Urology

摘　　要：目的探讨基于3D Slicer软件的三维重建技术在腹腔镜肾切除术处理肾血管中的应用价值。方法回顾性分析山东省聊城市人民医院2020年5月-2021年6月行经腹腹腔镜肾切除手术28例患者的临床资料,将肾脏强化CT数据导入3D Slicer软件进行三维重建,依据三维可视化模型,制定离断位置、离断顺序及离断方法的个体化肾血管处理方案。结果通过认知融合,27例患者均顺利显露出所有肾动脉和肾静脉。依据术前制定的肾血管处理方案,用Hem-O-lok先处理肾动脉,后处理肾静脉19例;用Hem-O-lok先处理肾静脉的部分属支,再用Hem-O-lok处理肾动脉,最后处理肾静脉的其余属支5例;用Hem-O-lok先处理肾动脉,后用腔镜直线型切割吻合器处理肾静脉4例。平均手术时间(135.4±51.8)min;平均出血量(60.4±42.2)mL,术后平均引流量(108.5±72.6)mL。结论应用3D Slicer软件重建包括肾血管在内的手术区域相关脏器的三维可视化模型,依此制定个体化的肾血管处理方案,有利于安全地显露和处理肾血管,减少出血风险,增加手术安全性。Objective To explore the application value of 3D reconstruction technology based on 3D Slicer software in renal vascular management of laparoscopic nephrectomy.Methods The clinical data of 28 patients who received transabdo-minal laparoscopic nephrectomy in our hospital during May 2020 and June 2021 were retrospectively analyzed.The renal CT data were imported into 3D Slicer software for 3D reconstruction.Based on the 3D visual model,individualized renal vascular management scheme of management position,sequence and method were formulated before operation.Results During operation,through the cognitive fusion of laparoscopic visual field and 3D visual model,all renal arteries and veins were successfully exposed in 27 cases.According to the renal vascular management plan formulated before operation,Hem-o-lok was used to clamp the renal arteries and then the veins in 19 cases;the generic branches of renal veins,arteries and then the other generic branches of renal veins in 5 cases.Hem-o-lok was used to clamp the renal arteries,and then endoscopic linear cutting stapler was used to clamp the renal veins in 4 cases.The average operation time was(135.4±51.8)min,bleeding volume(60.4±42.2)mL and drainage volume(108.5±72.6)mL.Conclusion The 3D Slicer software can be used to reconstruct the 3D visual model of relevant organs in the operation area,including renal vessels,and to formulate an individualized renal vessel treatment scheme,which is conducive to expose renal vessels,reduce the risk of bleeding and increase the safety of operation.

关 键 词：3D Slicer软件 肾切除 肾血管 三维重建 三维可视化 

分 类 号：R737.1[医药卫生—肿瘤]