Clinical Study Of 3D Laparoscopic Pyeloplasty

Background and PurposeThe ureteropelvic junction obstruction(UPJO)is a common clinical urinary malformation.The epidemiology shows that men are more common and people often occur on the left side,simultaneous onset of both sides is rare.The pathophysiological mechanism of UPJO is complicated and has many factors.Mostly it is caused by congenital stenosis,followed by high renal pelvis outlet,valve or wrinkles,ectopic blood vessels or congenital cords.Patients with mild disease will have hydronephrosis,and severe cases may occur decreased renal function and even uremia.Therefore,the early diagnosis and treatment of UPJO is an important research topic in urology.In clinical work,UPJO in the ultrasound showed renal pelvis enlargement without ureteral dilatation,combined with other imaging examinations,the general diagnosis is more clear.At present,there are many clinical treatment methods.The pyeloplasty is the most classic one.The treatment principle is mainly to remove the obstruction section,reconstruct the ureteropelvic junction,and make the urine flow smoothly,so as to protect the renal function of the patients.In recent years,urology has been one of the most active clinical departments in new technology application.Laparoscopy,which represents minimally invasive surgery,has been widely used in urologic surgery.It was originally used for varicocele and nephrectomy,further applied to surgery such as pyeloplasty.Laparoscopic surgery is deeply rooted in the heart with small trauma,reduced postoperative pain,and cosmetic properties,and is widely accepted by patients.While treating the disease,it can protect the patient’s function as much as possible and reduce the trauma to the patient.In the widespread application of laparoscopic surgery,the shortcomings of traditional 2D laparoscopic surgery have become more and more obvious.Traditional laparoscopic surgery based on 2D imaging principle cannot form stereoscopic vision,affecting the operator’s operation,especially when it involves fine operations such as cutting and anastomosis.3D Laparoscopy overcomes the drawbacks above.3D laparoscopy is a hot topic in recent years,and about its advantages and disadvantages in the operation of ureteropelvic junction obstruction,the past research is not much,Therefore,it is meaningful that 3D laparoscopic and traditional 2D laparoscopic surgery in pyeloplasty were compared to explore the advantage of 3D laparoscopic surgery in pyeloplasty.Materials and MethodsThe School and Hospital Ethics Review Board review and approve the collection of clinical data.Involving patients and their families signed the informed consent.The clinical data of UPJO patients diagnosed by the First Affiliated Hospital of Zhengzhou University from July 2015 to July 2017 were collected.A total of 78 patients were enrolled according to inclusion and exclusion criteria.According to whether 3D laparoscopic pyeloplasty was used or not,the two groups were divided into two groups.To explore the feasibility and effectiveness of 3D laparoscopy in pyeloplasty.The analysis was performed using SPSS 17.0 statistical software,P < 0.05 indicates that the difference was statistically significant.Results1.Compared with the 2D laparoscopic group,the operation time of the 3D laparoscopic group was less,and the difference was statistically significant(P<0.05).2.Compared with the 2D laparoscopic group,the amount of bleeding in the 3D laparoscopic group did not increase,and the difference was not statistically significant(P>0.05).3.Compared with the 2D laparoscopic group,the pain score of VAPS(24h)was not increased in the 3D laparoscopic group at 24 h after operation,and the difference was not statistically significant(P>0.05).4.Compared with the 2D laparoscopic group,the postoperative complications of the 3D laparoscopic group did not increase,and the difference was not statistically significant(P>0.05).5.Compared with the 2D laparoscopic group,the postoperative hospital stay in the 3D laparoscopic group did not increase,and the difference was not statistically significant(P>0.05).6.Compared with the 2D laparoscopic group,there was no increase in reocclusion after 3D laparoscopic surgery,and the difference was not statistically significant(P>0.05).7.The surgeon evaluates the operation experience of 3D laparoscopic surgery.The 3D laparoscopic lens can provide 3D stereoscopic vision,the image clarity is better,the operation intensity is reduced,and the coordination of hand and eye is increased,which is beneficial to fine anatomy and internal suture.artery at the junction of A zone and I zone is significantly higher.The difference is statistically significant(P<0.05).Conclusions1.3D laparoscopy is safer and more effective than 2D laparoscopy in pyeloplasty2.3D laparoscopy has obvious advantages in stereo operation during the operation,and its stereoscopic field makes the operation of free,shearing and suturing easier,and thus has important clinical value in minimally invasive urology.3.The surgeon evaluates the experience of 3D laparoscopic surgery.3D laparoscopy has better image definition,reducing surgical intensity,increasing hand-eye coordination,and is conducive to fine anatomy and internal suture.