Clinical Research

Application of 3D digital hologram and intraoperative navigation technology in laparoscopic partial nephrectomy

  • Cunyao LI ,
  • Xiaoliang YANG ,
  • Can WEI ,
  • Wei QI ,
  • Junfeng JING ,
  • Yanbin. ZHANG
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  • Department of Urology,Hefei Hospital Affiliated to Anhui Medical University (the Second People's Hospital of Hefei),Hefei 230011,Anhui,China

Received date: 2025-04-16

  Online published: 2025-07-29

Abstract

Objective To evaluate the feasibility and effectiveness of 3D digital holographic imaging combined with intraoperative navigation technology in the context of partial nephrectomy. Methods A total of 46 patients who underwent laparoscopic partial nephrectomy in the Department of Urology at the Second People's Hospital of Hefei City between June 2023 and January 2025 were randomly assigned to either the experimental group or the control group. The experimental group (n = 23) utilized preoperative planning and intraoperative real-time navigation based on 3D digital holographic imaging, whereas the control group (n = 23) relied on preoperative planning using optimized two-dimensional images obtained via contrast-enhanced CT and MRI scans. Preoperative data—including gender, age, body mass index (BMI), tumor diameter, and RENAL score—were collected. Intraoperative parameters such as total operative time, warm ischemia time, intraoperative blood loss, hemoglobin levels, postoperative hospitalization duration, and time to drain removal were recorded. Renal function changes were assessed by comparing serum creatinine levels and estimated glomerular filtration rates (eGFR) before surgery and one month post-surgery. Additionally, the incidence of intraoperative complications—particularly injury to the renal collecting system—and postoperative complications—including positive surgical margins, bleeding, subcutaneous emphysema, and urinary fistula—was analyzed. Results In this study, holographic images were successfully reconstructed for 23 patients with renal tumors in the experimental group. Each anatomical structure—including the kidney and tumor lesions, collecting system, renal arteries and veins, adrenal glands, and inferior vena cava—was color-coded to enable intuitive visualization. These images were used for preoperative planning and provided real-time spatial orientation to accurately locate and guide resection of the tumor during surgery. In the control group, 23 patients underwent preoperative planning based on contrast-enhanced CT and MRI scans acquired using optimized parameters. All 46 patients underwent laparoscopic partial nephrectomy performed by the same qualified surgeon, and postoperative pathological analysis confirmed renal tumors, including 27 cases of clear cell carcinoma, 7 cases of chromophobe cell carcinoma, 5 cases of papillary cell carcinoma, 2 cases of sarcomatoid carcinoma, and 5 cases of angiomyolipoma. No significant differences were observed in baseline clinical characteristics (including age, body mass index, tumor diameter, and RENAL score) between the two groups (P > 0.05). The experimental group showed significantly lower values in total operative time, warm ischemia time, intraoperative blood loss, pre- to postoperative hemoglobin changes, and pre-surgical to one-month post-surgical creatinine changes compared to the control group (P < 0.01). Additionally, the experimental group exhibited smaller changes in hospitalization duration, time to drain removal, and glomerular filtration rate from preoperative to one month post-surgery; however, these differences were not statistically significant (P = 0.175, P = 0.331, and P = 0.273). There were no intraoperative complications or damage to the collecting system in either the experimental or control groups. Postoperatively, the control group experienced one case of positive surgical margin, one case of hemorrhage, and one case of subcutaneous emphysema. No statistically significant differences were observed between the groups (P > 0.05). Conclusions 3D digital holographic imaging combined with intraoperative navigation technology, based on the fusion of MRI and CT data, facilitates preoperative planning and precise intraoperative guidance. This approach helps reduce operative time, preserve renal function, and lower perioperative risks while ensuring therapeutic efficacy.

Cite this article

Cunyao LI , Xiaoliang YANG , Can WEI , Wei QI , Junfeng JING , Yanbin. ZHANG . Application of 3D digital hologram and intraoperative navigation technology in laparoscopic partial nephrectomy[J]. The Journal of Practical Medicine, 2025 , 41(14) : 2191 -2198 . DOI: 10.3969/j.issn.1006-5725.2025.14.010

References

[1] BUKAVINA L, BENSALAH K, BRAY F, et al. Epidemiology of renal cell carcinoma: 2022 update[J]. Eur Urol, 2022, 82(5): 529-542. doi:10.1016/j.eururo.2022.08.019
[2] BAHADORAM S, DAVOODI M, HASSANZADEH S, et al. Renal cell carcinoma: An overview of the epidemiology, diagnosis, and treatment[J]. G Ital Nefrol, 2022, 39(3): 2022.
[3] WEI L, WANG C, FU J, et al. Holographic 3D renal segments reconstruction protects renal function by promote choice of selective renal artery clamping during robot-assisted partial nephrectomy[J]. World J Urol, 2023, 41(11): 2975-2983. doi:10.1007/s00345-023-04599-2
[4] GAO Y, LI H, YAO Y, et al. Vessel and tension-free reconstruction during robot-assisted partial nephrectomy for hilar tumors:“garland” technique and midterm outcomes[J]. J Endourol, 2020, 34(4): 469-474. doi:10.1089/end.2019.0792
[5] DESAI S, RAC G, PATEL H D, et al. Imaging features of renal masses to select optimal candidates for tumor enucleation partial nephrectomy[J]. Curr Urol Rep, 2022, 23(12): 345-353. doi:10.1007/s11934-022-01121-w
[6] D'AIELLO A F, BOGNONI L, BEVILACQUA F, et al. Holographic Techniques as a Novel Method for Intervention Planning: A Tertiary Centres Experience[J]. Curr Health Sci J, 2023, 49(4): 584.
[7] 陈建新,沈海平,袁燕文,等. 三维可视化技术在腹腔镜结直肠癌D3根治术中应用价值[J]. 实用医学杂志,2022,38(12):1533-1540.
[8] 陈梓键, 王峻峰, 余闫宏, 等. 混合现实技术对腹腔镜下肿瘤动脉阻断肾部分切除手术的指导价值[J]. 临床泌尿外科杂志, 2021, 36(4): 310-313.
[9] 何跃,张海梁,秦晓健,等. 保留肾单位手术治疗完全内生性中央型肾肿瘤20例报告[J]. 临床泌尿外科杂志,2018,33(4):325-326,330.
[10] 陆智强,张艳斌,席俊华,等. 男性盆腔三维数字化重建在腹腔镜前列腺癌根治术中的应用[J]. 实用临床医药杂志,2022,26(5):1-5.
[11] PHUNG M C, LEE B R. Recent advancements of robotic surgery for kidney cancer[J]. Asian J Endosc Surg, 2018, 11(4): 300-307. doi:10.1111/ases.12635
[12] LJUNGBERG B, ALBIGES L, ABU-GHANEM Y, et al. European association of urology guidelines on renal cell carcinoma: The 2019 update[J]. Eur Urol, 2019, 75(5): 799-810.
[13] HUNG A J, CAI J, SIMMONS M N, et al. "Trifecta" in partial nephrectomy[J]. J Urol, 2013, 189(1): 36-42. doi:10.1016/j.juro.2012.09.042
[14] 刘高,王祥宇,方先林,等. 基于CT的可视化三维影像重建技术在腹腔镜肾部分切除手术中的临床应用研究[J]. 世界复合医学,2022,8(10):6-10.
[15] 张童鑫,艾龙龙,张玉江,等. 三维可视化技术与二维影像比较辅助肝切除术临床效果的Meta分析[J]. 中国循证医学杂志,2018,18(8):850-857
[16] 付坚,王聪,何鹏,等. 全息影像CT三维重建技术在机器人辅助腹腔镜肾部分切除术中的应用研究[J]. 临床泌尿外科杂志,2022,37(9):698-701,707.
[17] 吕建敏,潘秀武,干思舜,等. 三维智能定性定量分析系统在双肾肿瘤精准手术规划、模拟及实施中的应用效果分析[J]. 中华泌尿外科杂志,2019,40(5):356-360.
[18] 李新飞,彭意吉,余霄腾,等. 肾部分切除术前CT三维可视化评估标准的初步探究[J]. 北京大学学报(医学版),2021,53(3):613-622.
[19] LIANG C, ZHU J, MIAO C, et al. Protective Effects of the Segmental Renal Artery Clamping Technique on Ischemia‐Reperfusion Injury in db/db Diabetic Mice[J]. Biomed Res Int, 2017, 2017(1): 4763828. doi:10.1155/2017/4763828
[20] NGUYEN M M, GILL I S. Halving ischemia time during laparoscopic partial nephrectomy[J]. J Urol, 2008, 179(2): 627-632. doi:10.1016/j.juro.2007.09.086
[21] WU X, LIU R, YU J, et al. Mixed reality technology–assisted orthopedics surgery navigation[J]. Surg Innov, 2018, 25(3): 304-305. doi:10.1177/1553350618771413
[22] 张凯,朱刚,李鸿波,等. 三维影像重建在泌尿外科机器人手术中的应用[J]. 中华泌尿外科杂志,2018,39(9): 690-693.
[23] 冯超,申玉兰,陈磊,等. 多模态三维影像重建技术在尿道狭窄诊断中的应用[J]. 中华泌尿外科杂志,2018,39(5):367-371
[24] 王振龙,李晓会,李和程,等. 3D打印模型或CT三维重建指导下的肿瘤四点定位法在完全内生型肾癌腹腔镜下肾部分切除术中的应用[J]. 中华泌尿外科杂志, 2016, 37(10): 735-739.
[25] 燕荣帅,李翔,肖晶晶,等. 混合现实技术在整形外科教学中的应用探索[J]. 中国美容医学, 2018, 27(2): 140-142.
[26] 朱凯,罗建斌. 全息影像腹腔镜融合技术在肾肿瘤切除术中的临床效果观察[J]. 中国现代药物应用,2023,17(22):61-63
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