Factors affecting the use of a three‐dimensional model during robot‐assisted partial nephrectomy

• Published in: Asian journal of endoscopic surgery Vol. 17; no. 2; pp. e13301 - n/a
• Main Authors: Yamazaki, Masahiro, Takayama, Tatsuya, Sugihara, Toru, Kikuchi, Tomohiro, Kamimura, Tomoki, Kamei, Jun, Ando, Satoshi, Terauchi, Fumihito, Morita, Tatsuo, Fujimura, Tetsuya
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-04-2024; Wiley Subscription Services, Inc
• Subjects: nephrectomy; partial; Robots; three‐dimensional; partial; nephrectomy; three-dimensional
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.13301

Introduction
This study aimed to identify cases that require a three‐dimensional‐printed kidney model in robot‐assisted partial nephrectomy.
Methods
We enrolled 93 patients undergoing robot‐assisted partial nephrectomy for renal tumors at a single institution between November 2018 and May 2021. The endpoints were how often and how long the surgeon consulted the three‐dimensional‐printed model, determined using intraoperative video. Multivariate analyses of the endpoints were adjusted by preoperative patient and kidney characteristics, including renal vascular complexity that was defined as the number of vascular branches penetrating the surface tangential to the ventral side of the kidney.
Results
Of the 93 cases, the median frequency and duration of intraoperative three‐dimensional‐printed model consultation were four times and 39 s, respectively. The multivariate linear regression analyses showed that the frequency of intraoperative three‐dimensional‐printed model consultation by the surgeon was significantly related to the complexity of the arterial structure (≥4 branches), presence of hilar tumor, and high Mayo Adhesive Probability score; the regression coefficients were 1.81, 2.79, and 1.34, respectively. All p‐values were ≤.03. The duration of the three‐dimensional‐printed model consultation was significantly related to the complexity of the arterial structure (≥4 branches) and the presence of hilar tumor; the regression coefficients were 21.6, and 29.0 s, respectively. All p‐values were <.01.
Conclusion
During robot‐assisted partial nephrectomy, a three‐dimensional‐printed model would be helpful in cases with a complex arterial structure or hilar tumor.