AUA 209: Immersive Virtual Reality (iVR) Renal Models as an Educational and Preoperative Planning Tool for Laparoscopic Donor Nephrectomy: Initial Experience

Chicago, IL ( In light of the shortcomings of traditional two-dimensional imaging modalities such as CT and MRI, researchers at the University of California, Irvine sought to assess virtual reality models as a preoperative planning tool for laparoscopic donor nephrectomy. 

The investigators recruited 14 patients undergoing donor nephrectomy, and used the patients’ CT images to create patient-specific volumetric renderings, which were viewed in an immersive virtual reality environment using the Oculus Rift headset (the same one that’s used for virtual reality video games) (Figure 1). Surgeons and patients responded to questionnaires preoperatively regarding their understanding of the planned nephrectomy and the renal anatomy. Surgeons also rated the accuracy of the models postoperatively. Operative outcomes were recorded. 

Preoperatively, surgeons reported that the virtual reality models enhanced their understanding of the patient’s anatomy (e.g. renal vasculature, ureter). The models also improved patients’ understanding of the anatomy and reduced their preoperative anxiety. Surgeons also reported that the virtual reality models accurately reflected the surgical anatomy. In addition, when compared to a retrospectively matched cohort, preoperative preparation with virtual reality models was associated with a significantly shorter operative time for both hand-assisted and standard laparoscopic methods.

The presentation was followed by a discussion regarding the future of virtual and augmented reality in medical imaging. 
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Figure 1.
(A-B): iVR model of laparoscopic donor nephrectomy patient.
(C-D): CT images of the same patient. 
A) Anterior coronal view of the anatomy demonstrating a circumaortic branch of the left renal vein as it passes anterior (green arrow) and posterior (red arrow) to the aorta. 
B) Posterior coronal view of anatomy with virtual hand pointing to retroaortic component of renal vein. 
C) Sagittal view showing branching of circumaortic left renal vein. 
D) Axial view. 

Presented and Written by Francis Jefferson, Department of Urology, University of California-Irvine) at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois