V04-07 CONE-BEAM COMPUTED TOMOGRAPHY IN A HYBRID OPERATING ROOM FOR DETECTION OF RESIDUAL STONES DURING PERCUTANEOUS NEPHROLITHOTOMY

2020 ◽  
Vol 203 ◽  
pp. e389
Author(s):  
Riemer A. Kingma ◽  
Maarten J.H. Voskamp ◽  
Benjamin H.J. Doornweerd ◽  
Igle J. de Jong ◽  
Stijn Roemeling*
Keyword(s):  
Computed Tomography ◽  
Operating Room ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Hybrid Operating Room ◽  
Residual Stones

scholarly journals Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy: a feasibility study

Urolithiasis ◽  
2021 ◽  
Author(s):  
R. A. Kingma ◽  
M. J. H. Voskamp ◽  
B. H. J. Doornweerd ◽  
I. J. de Jong ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
University Hospital ◽  
Cone Beam ◽  
Cross Sectional ◽  
The Mean ◽  
Residual Stones ◽  
Residual Fragments

AbstractCone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible.

scholarly journals Safety and accuracy of spinal instrumentation surgery in a hybrid operating room with an intraoperative cone-beam computed tomography

2018 ◽  
Vol 42 (2) ◽  
pp. 417-426 ◽  
Author(s):  
Christian A. Bohoun ◽  
Kentaro Naito ◽  
Toru Yamagata ◽  
Samantha Tamrakar ◽  
Kenji Ohata ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Operating Room ◽  
Cone Beam Computed Tomography ◽  
Spinal Instrumentation ◽  
Cone Beam ◽  
Hybrid Operating Room

scholarly journals Intra-operative cone-beam computed tomography for detecting residual stones in percutaneous nephrolithotomy

2020 ◽  
Vol 19 ◽  
pp. e2332
Author(s):  
R.A. Kingma ◽  
M.J.H. Voskamp ◽  
B.H.J. Doornweerd ◽  
I.J. De Jong ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
Cone Beam ◽  
Residual Stones

scholarly journals Simultaneous cone beam computed tomography‐guided bronchoscopic marking and video‐assisted thoracoscopic wedge resection in a hybrid operating room

2019 ◽  
Vol 10 (3) ◽  
pp. 579-582 ◽  
Author(s):  
Takashi Anayama ◽  
Kentaro Hirohashi ◽  
Hironobu Okada ◽  
Ryohei Miyazaki ◽  
Nobutaka Kawamoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Operating Room ◽  
Cone Beam Computed Tomography ◽  
Wedge Resection ◽  
Cone Beam ◽  
Hybrid Operating Room ◽  
Video Assisted

scholarly journals Cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy, a randomized controlled trial (CAPTURE) protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. A. Kingma ◽  
I. J. de Jong ◽  
M. J. W. Greuter ◽  
S. Roemeling
Keyword(s):  
Computed Tomography ◽  
Randomized Controlled Trial ◽  
Percutaneous Nephrolithotomy ◽  
Cone Beam Computed Tomography ◽  
Controlled Trial ◽  
Cone Beam ◽  
Total Study Population ◽  
Randomized Controlled ◽  
Free Status

Abstract Introduction Percutaneous nephrolithotomy (PCNL) is the standard surgical treatment method for large kidney stones. Its aim is to achieve a stone-free status, since any residual fragments (RFs) after PCNL are likely to cause additional morbidity or stone growth. Enhancing intraoperative detectability of RFs could lead to increased stone-free rates and decreased re-intervention rates. Cone beam computed tomography (CBCT) has recently been introduced in urology as a feasible method for intraoperatively imaging RFs. The aim of this trial is to determine the added value of CBCT in percutaneous nephrolithotomy, by measuring differences in stone-related morbidity for patients with procedures in which a CBCT is used versus patients with procedures without the use of CBCT. Methods The CAPTURE trial is an investigator-initiated single-center, randomized controlled trial (RCT) in adult patients who have an indication for percutaneous nephrolithotomy. A contemporary percutaneous nephrolithotomy is performed. Once the surgeon is convinced of a stone-free status by means of fluoroscopy and nephroscopy, randomization allocates patients to either the study group in whom an intraoperative CBCT scan is performed or to the control group in whom no intraoperative CBCT scan is performed. The main endpoint is the stone-free status as assessed four weeks postoperatively by low-dose non-contrast abdominal CT, as a standard follow-up procedure. Secondary endpoints include the number of PCNL procedures required and the number of stone-related events (SREs) registered. The total study population will consist of 320 patients that undergo PCNL and are eligible for randomization for an intraoperative CBCT scan. Discussion We deem a randomized controlled trial to be the most effective and reliable method to assess the efficacy of CBCT in PCNL. Though some bias may occur due to the impossibility of blinding the urologist at randomization, we estimate that the pragmatic nature of the study, standardized circumstances, and follow-up methods with pre-defined outcome measures will result in a high level of evidence. Trial registration Netherlands Trial Register (NTR) NL8168, ABR NL70728.042.19. Registered on 15 October 2019. Prospectively registered.

Operating room radiation exposure in cone beam computed tomography–based, image-guided spinal surgery

2013 ◽  
Vol 19 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Eric W. Nottmeier ◽  
Stephen M. Pirris ◽  
Steven Edwards ◽  
Sherri Kimes ◽  
Cammi Bowman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Operating Room ◽  
Cone Beam Computed Tomography ◽  
Spinal Surgery ◽  
Image Guidance ◽  
Cone Beam ◽  
3D Image ◽  
Image Guided ◽  
Radiation Scatter

Object Surgeon and operating room (OR) staff radiation exposure during spinal surgery is a concern, especially with the increasing use of multiplanar fluoroscopy in minimally invasive spinal surgery procedures. Cone beam computed tomography (cbCT)–based, 3D image guidance does not involve the use of active fluoroscopy during instrumentation placement and therefore decreases radiation exposure for the surgeon and OR staff during spinal fusion procedures. However, the radiation scatter of a cbCT device can be similar to that of a standard 64-slice CT scanner and thus could expose the surgeon and OR staff to radiation during image acquisition. The purpose of the present study was to measure radiation exposure at several unshielded locations in the OR when using cbCT in conjunction with 3D image-guided spinal surgery in 25 spinal surgery cases. Methods Five unshielded badge dosimeters were placed at set locations in the OR during 25 spinal surgery cases in which cbCT-based, 3D image guidance was used. The cbCT device (O-ARM) was used in conjunction with the Stealth S7 image-guided platform. The radiology department analyzed the badge dosimeters after completion of the last case. Results Fifty high-definition O-ARM spins were performed in 25 patients for spinal registration and to check instrumentation placement. Image-guided placement of 124 screws from C-2 to the ileum was accomplished without complication. Badge dosimetry analysis revealed minimal radiation exposure for the badges 6 feet from the gantry in the area of the anesthesiology equipment, as well as for the badges located 10–13 feet from the gantry on each side of the room (mean 0.7–3.6 mrem/spin). The greatest radiation exposure occurred on the badge attached to the OR table within the gantry (mean 176.9 mrem/spin), as well as on the control panel adjacent to the gantry (mean 128.0 mrem/spin). Conclusions Radiation scatter from the O-ARM was minimal at various distances outside of and not adjacent to the gantry. Although the average radiation exposure at these locations was low, an earlier study, undertaken in a similar fashion, revealed no radiation exposure when the surgeon stood behind a lead shield. This simple precaution can eliminate the small amount of radiation exposure to OR staff in cases in which the O-ARM is used.

Sign in / Sign up

Export Citation Format

Share Document