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Gomes-Fonseca J, Veloso F, Queirós S, Morais P, Pinho ACM, Fonseca JC, Correia-Pinto J, Lima E, Vilaça JL. Technical Note: Assessment of electromagnetic tracking systems in a surgical environment using ultrasonography and ureteroscopy instruments for percutaneous renal access. Med Phys 2019; 47:19-26. [PMID: 31661566 DOI: 10.1002/mp.13879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/01/2019] [Accepted: 10/21/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Electromagnetic tracking systems (EMTSs) have been proposed to assist the percutaneous renal access (PRA) during minimally invasive interventions to the renal system. However, the influence of other surgical instruments widely used during PRA (like ureteroscopy and ultrasound equipment) in the EMTS performance is not completely known. This work performs this assessment for two EMTSs [Aurora® Planar Field Generator (PFG); Aurora® Tabletop Field Generator (TTFG)]. METHODS An assessment platform, composed by a scaffold with specific supports to attach the surgical instruments and a plate phantom with multiple levels to precisely translate or rotate the surgical instruments, was developed. The median accuracy and precision in terms of position and orientation were estimated for the PFG and TTFG in a surgical environment using this platform. Then, the influence of different surgical instruments (alone or together), namely analogic flexible ureterorenoscope (AUR), digital flexible ureterorenoscope (DUR), two-dimensional (2D) ultrasound (US) probe, and four-dimensional (4D) mechanical US probe, was assessed for both EMTSs by coupling the instruments to 5-DOF and 6-DOF sensors. RESULTS Overall, the median positional and orientation accuracies in the surgical environment were 0.85 mm and 0.42° for PFG, and 0.72 mm and 0.39° for TTFG, while precisions were 0.10 mm and 0.03° for PFG, and 0.20 mm and 0.12° for TTFG, respectively. No significant differences were found for accuracy between EMTSs. However, PFG showed a tendency for higher precision than TTFG. AUR, DUR, and 2D US probe did not influence the accuracy and precision of both EMTSs. In opposition, the 4D probe distorted the signal near the attached sensor, making readings unreliable. CONCLUSIONS Ureteroscopy- and ultrasonography-assisted PRA based on EMTS guidance are feasible with the tested AUR or DUR together with the 2D probe. More studies must be performed to evaluate the probes and ureterorenoscopes' influence before their use in PRA based on EMTS guidance.
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Affiliation(s)
- João Gomes-Fonseca
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal
| | - Fernando Veloso
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,Department of Mechanical Engineering, School of Engineering, University of Minho, Guimarães, Portugal.,2Ai, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal
| | - Sandro Queirós
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,2Ai, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal
| | - Pedro Morais
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,2Ai, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal
| | - António C M Pinho
- Department of Mechanical Engineering, School of Engineering, University of Minho, Guimarães, Portugal
| | - Jaime C Fonseca
- Algoritmi Center, School of Engineering, University of Minho, Guimarães, Portugal.,Department of Industrial Electronics, School of Engineering, University of Minho, Guimarães, Portugal
| | - Jorge Correia-Pinto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,Department of Pediatric Surgery, Hospital of Braga, Braga, Portugal
| | - Estêvão Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,Deparment of Urology, Hospital of Braga, Braga, Portugal
| | - João L Vilaça
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,Government Associate Laboratory, ICVS/3B's-PT, Braga/Guimarães, Portugal.,2Ai, Polytechnic Institute of Cávado and Ave, Barcelos, Portugal
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Nguyen DD, Luo JW, Tailly T, Bhojani N. Percutaneous Nephrolithotomy Access: A Systematic Review of Intraoperative Assistive Technologies. J Endourol 2019; 33:358-368. [DOI: 10.1089/end.2019.0085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | - Jack W. Luo
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Thomas Tailly
- Urology Department, University Hospital Ghent, Ghent, Belgium
| | - Naeem Bhojani
- Division of Urology, University of Montreal Health Center (CHUM), Montreal, Canada
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