Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 16:2022:8992051.
doi: 10.1155/2022/8992051. eCollection 2022.

Role and Utility of Mixed Reality Technology in Laparoscopic Partial Nephrectomy: Outcomes of a Prospective RCT Using an Indigenously Developed Software

Nariman Gadzhiev  1 , Igor Semeniakin  2 , Aleksandr Morshnev  3 , Antonio Alcaraz  4 , Vineet Gauhar  5 , Zhamshid Okhunov  6
Affiliations

Role and Utility of Mixed Reality Technology in Laparoscopic Partial Nephrectomy: Outcomes of a Prospective RCT Using an Indigenously Developed Software

Nariman Gadzhiev et al. Adv Urol. .

Abstract

Objective: To develop a software for mixed reality (MR) anatomical model creation and study its intraoperative clinical utility to facilitate laparoscopic partial nephrectomy.

Materials and methods: After institutional review board approval, 47 patients were prospectively randomized for LPN into two groups: the control group (24 patients) underwent operation with an intraoperative ultrasound (US) control and the experimental group (23 patients) with smart glasses HoloLens 2 (Microsoft, Seattle, WA, USA). Our team has developed an open-source software package called "HLOIA," utilization of which allowed to create and use during surgery the MR anatomical model of the kidney with its vascular pedicle and tumor. The study period extended from June 2020 to February 2021 where demographic, perioperative, and pathological data were collected for all qualifying patients. The objective was to assess the utility of a MR model during LPN and through a 5-point Likert scale questionnaire, completed by the surgeon, immediately after LPN. Patient characteristics were tested using the chi-square test for categorical variables and Student's t-test or Mann-Whitney test for continuous variables.

Results: Comparison of the variables between the groups revealed statistically significant differences only in the following parameters: the time for renal pedicle exposure and the time from the renal pedicle to the detection of tumor localization (p < 0.001), which were in favor of the experimental group. The surgeon's impression of the utility of the MR model by the proposed questionnaire demonstrated high scores in all statements.

Conclusions: Developed open-source software "HLOIA" allowed to create the mixed reality anatomical model by operating urologist which is when used with smart glasses has shown improvement in terms of time for renal pedicle exposure and time for renal tumor identification without compromising safety.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flow of participants in the “mixed reality technology for LPN” study.
Figure 2
Figure 2
HLOIA's web application 3D editor desktop.
Figure 3
Figure 3
Transparent 3D mixed reality model anchored in front of the surgeon and matched to the real-time videoendoscopic picture during LPN.
Figure 4
Figure 4
Time parameters for renal pedicle exposure (a) and for tumor location determination (b).
Figure 5
Figure 5
Radar chart for questionnaire answer options.
Figure 6
Figure 6
Difference between 3 main domains of immersive technology: VR is an artificial world; AR is an object of augmented reality seen on the screen; MR is a 3D object seen as a hologram which is totally controllable.
See this image and copyright information in PMC

References

    1. Campbell S., Uzzo R. G., Allaf M. E., et al. Renal mass and localized renal cancer: AUA guideline. The Journal of Urology . 2017;198(3):520–529. doi: 10.1016/j.juro.2017.04.100. - DOI - PubMed
    1. You C., Du Y., Wang H., et al. Laparoscopic versus open partial nephrectomy: a systemic review and meta-analysis of surgical, oncological, and functional outcomes. Frontiers in Oncology . 2020;10:1–11. doi: 10.3389/fonc.2020.583979. - DOI - PMC - PubMed
    1. Gong E. M., Orvieto M. A., Zorn K. C., Lucioni A., Gary D. S., Shalhav A. L. Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors. Journal of Endourology . 2008;22(5):953–958. doi: 10.1089/end.2007.0300. - DOI - PubMed
    1. Orvieto M. A., Chien G. W., Tolhurst S. R., et al. Simplifying laparoscopic partial nephrectomy: technical considerations for reproducible outcomes. Urology . 2005;66(5):976–980. doi: 10.1016/j.urology.2005.05.013. - DOI - PubMed
    1. Raison N., Doeuk N., Malthouse T., Kasivisvanathan V., Lam W., Ben C. Challenging situations in partial nephrectomy. International Journal of Surgery . 2016;36:568–573. doi: 10.1016/j.ijsu.2016.05.070. - DOI - PubMed