Interactive Virtual Reality Renal Models as an Educational and Preoperative Planning Tool for Laparoscopic Donor Nephrectomy

• Published in: Urology (Ridgewood, N.J.) Vol. 153; pp. 192 - 198
• Main Authors: Xie, Lillian, O'Leary, Mitchell, Jefferson, Francis A., Karani, Rajiv, Limfueco, Luke, Parkhomenko, Egor, Sung, John M., Patel, Roshan M., Ichii, Hirohito, Dafoe, Donald, Clayman, Ralph V., Landman, Jaime
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2021
• Subjects: Adult; Female; Humans; Kidney Transplantation - education; Kidney Transplantation - methods; Male; Models, Anatomic; Nephrectomy - education; Nephrectomy - methods; Outcome Assessment, Health Care; Patient Care Planning; Patient Education as Topic - methods; Preoperative Care - methods; Retrospective Studies; Tissue and Organ Harvesting - education; Tissue and Organ Harvesting - methods; Tissue and Organ Harvesting - psychology; Tissue Donors - education; Tissue Donors - psychology; Virtual Reality
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2020.12.046

To evaluate the efficacy of interactive virtual reality (iVR) in providing a three-dimensional (3D) experience with the donor's anatomy for surgeons and patients, we present a retrospective, case-controlled study assessing the impact of iVR renal models prior to LDN on both surgical outcomes and patients’ understanding of the procedure.
Twenty patients undergoing LDN were prospectively recruited; their contrast-enhanced CT scans were transformed into iVR models. An iVR platform allowed the surgeons to rotate and deconstruct the renal anatomy; patients could also view their anatomy as the procedure was explained to them. Questionnaires assessed surgeons’ understanding of renal anatomy after CT alone and after CT+iVR. Surgeons also commented on whether iVR impacted their preoperative plan. Patients assessed their anatomical understanding and anxiety level before and after iVR. Surgical outcomes for the iVR cohort were compared to a retrospectively matched, non-iVR cohort of LDN patients.
Surgeons altered their preoperative plan in 18 of 20 LDNs after viewing iVR models. Patients reported better understanding of their anatomy (5/5) and noted decreased preoperative anxiety (5/5) after viewing iVR. When compared to the non-iVR group, the iVR group had a 25% reduction in median operative time (P < .001). In terms of surgical outcomes, patients in the iVR group had a 40% lower median relative change in postoperative creatinine (P < .001).
Preoperative viewing of iVR models altered the operative approach, decreased the operative time, and improved donor patient outcomes. iVR models also reduced patients’ preoperative anxiety.