Role of virtual reality in improving the spatial perception of the kidney during flexible ureteroscopy: A feasibility study using virtual reality simulators and 3D models

Abstract

Background: The aims were to describe a software-based reconstruction of the patient-specific kidney cavity intraluminal appearance via a head-mounted device and to estimate its feasibility for training novices.

Materials and methods: In total, 15 novices were recruited. Each novice was shown a three-dimensional reconstruction of a patient’s computed tomography scan, whose kidney was printed. They then joined the surgeon in the operating room and assisted them in detecting the stone during flexible ureteroscopy on the printed model. Then, each participant did a 7-day virtual reality (VR) study followed by virtual navigation of the printed kidney model and came to the operating room to help the surgeon with ureteroscope navigation. The length of the procedure and the number of attempts to find the targeted calyx were compared.

Results: With VR training, the length of the procedure (p = 0.0001) and the number of small calyces that were incorrectly identified as containing stones were significantly reduced (p = 0.0001). All the novices become highly motivated to improve their endourological skills further. Participants noticed minimal values for nausea and for disorientation. However, oculomotor-related side effects were defined as significant. Five specialists noticed a good similarity between the VR kidney cavity representation and the real picture, strengthening the potential for the novice’s education via VR training.

Conclusions: Virtual reality simulation allowed for improved spatial orientation within the kidney cavity by the novices and could be a valuable option for future endourological training and curricula.

Keywords

Ureteroscopy / Kidney calculi / Virtual reality / Endourology / Training / Nephroscopy / 3D

Acknowledgments

The authors thank Boston Scientific for the single-use flexible ureteroscopes LithoVue and stone models provided for the study.

Statement of ethics

This study was approved by Mariinsky Hospital, Saint Petersburg, Russia, with an ethical approval number ERN1032. Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest statement

The authors declare they have no conflicts of interest

Funding source

None.

Author contributions

AT: Design and conduct of the study, collection of the data, management of the data, analysis, interpretation of the data, preparation, review and approval of the manuscript;

BMZH, UZ MSS: Collection of the data review, analysis, interpretation of the data, preparation and approval of the manuscript;

NN, MS, AS, BG: Collection of the data review, interpretation of the data and approval of the manuscript;

PJ-J: Interpretation of the data, editing, review and approval of the manuscript, supervision;

BKS: Review and approval of the manuscript, supervision.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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