Mon Mon Oo1, Himesh Ramesh Gandhi1,2, Kian Tai Chong1,3, Jin Quan Goh4, Ka Wei Ng4, Aung Thaw Hein5, Yung Khan Tan1. 1. Department of Urology, Tan Tock Seng Hospital, Singapore. 2. Department of Urology and Robotic Surgery, Ruby Hall Clinic, Pune, India. 3. PanAsia Surgery, Mount Elizabeth Novena Hospital, Singapore. 4. NDR Medical Technology, Pte. Ltd, Singapore. 5. Department of Urology, Military Hospital, Yangon, Myanmar.
Abstract
INTRODUCTION: To make percutaneous access easier in PCNL, we developed Automated Needle Targeting with X-ray (ANT-X). METHOD: ANT-X uses an image registration software with a closed loop feedback system to autoalign the puncture needle to the desired calyx using the bullseye technique. We tried percutaneous punctures on a live pig model and compared the results with free-hand technique. We then performed our first PCNL in a human subject with the aid of ANT-X. Our patient was a 48 year-old gentleman with a 1.4cm left lower pole stone. RESULTS: Initial results for live animal trial showed radiation exposure for robot-assisted arm during puncture was reduced by 26% compared to the free-hand technique (8.2mGy vs 11.2mGy). In the human trial, obtaining percutaneous access was successful at first attempt. CONCLUSION: ANT-X system can help surgeons feel confident and potentially reduce complications, hence enabling more surgeons to adopt this procedure.
INTRODUCTION: To make percutaneous access easier in PCNL, we developed Automated Needle Targeting with X-ray (ANT-X). METHOD: ANT-X uses an image registration software with a closed loop feedback system to autoalign the puncture needle to the desired calyx using the bullseye technique. We tried percutaneous punctures on a live pig model and compared the results with free-hand technique. We then performed our first PCNL in a human subject with the aid of ANT-X. Our patient was a 48 year-old gentleman with a 1.4cm left lower pole stone. RESULTS: Initial results for live animal trial showed radiation exposure for robot-assisted arm during puncture was reduced by 26% compared to the free-hand technique (8.2mGy vs 11.2mGy). In the human trial, obtaining percutaneous access was successful at first attempt. CONCLUSION: ANT-X system can help surgeons feel confident and potentially reduce complications, hence enabling more surgeons to adopt this procedure.