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Could Virtual Reality Models for Surgical Planning Improve Nephrectomy Outcomes?

By: Hillary Ojeda
Posted: Thursday, October 31, 2019

Using three-dimensional (3D) virtual reality models to assist in planning robotic-assisted partial nephrectomies may ultimately improve outcomes, potentially reducing blood loss, operative time, and length of hospital stay, according to a randomized clinical trial published in JAMA Network Open. James R. Porter, MD, of the Swedish Urology Group, Seattle, and colleagues suggest their study results may impact future preoperative planning for patients with kidney cancer.

“Novel forms of surgical planning, such as those involving 3D virtual reality models, could help improve the surgeon’s understanding of the patient’s anatomy and optimal surgical approach,” the investigators proposed. “The 3D virtual reality models also may have reduced the cognitive load demanded of surgeons; they simply reduced the amount of information that the surgeon needed to process.”

A total of 92 patients undergoing robotic-assisted partial nephrectomy were enrolled in the single-blind study. The nephrectomies were performed by 1 of 11 surgeons at 6 large teaching hospitals. Patients were randomly assigned nearly evenly to one of two groups: a control group that included CT and/or MRI in preoperative planning or an intervention group that added the use of a 3D virtual reality model. Surgeons viewed the model from their smartphones and a virtual reality headset. Data were collected between October 2017 and December 2018. The investigators controlled for case complexity and other covariates. Patients who received surgical planning with the virtual reality models had reduced operative time (odds ratio [OR] = 1.00; confidence interval [CI] = 0.37–2.70), estimated blood loss (OR = 1.98; 95% CI = 1.04–3.78), clamp time (OR = 1.60; 95% CI = 0.79–3.23), and length of hospital stay (OR – 2.86; 95% CI = 1.59–5.14).

Disclosure: The study authors’ disclosure information can be found at jamanetwork.com.



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