Grant: Alliance Grants

One in ten Canadians will develop kidney stones during their lifetime. Percutaneous nephrolithotomy (PCNL) is a procedure to remove large kidney stones via a small incision in the patient's back under fluoroscopy or ultrasound imaging guidance. Despite over 40 years of development, PCNL remains a complex procedure to master and is associated with a high risk of complications. In fact, novice surgeons only achieve excellence in the procedure after performing 115 surgeries. Such a steep learning curve is commonly attributed to the extraordinary level of dexterity required to navigate the surgical tools under 2-dimensional imaging. Fluoroscopy is the preferred imaging modality in PCNL, however, ultrasound has been emerging as an easier-to-learn alternative. The uptake of ultrasound-guided PCNL in Canada has been limited, largely because of the lack of training opportunities. Marion Surgical has developed a virtual reality (VR) simulator that enables urologists to immerse in a virtual operating room to practice PCNL in a controlled environment. Currently, their simulator only supports fluoroscopic imaging. This collaboration builds upon preliminary work between Marion Surgical and Carleton researchers and aims at: (1) expanding the capabilities of Marion's simulator to support ultrasound images, and (2) studying the feasibility of robot-aided PCNL to decrease the surgeon's cognitive workload and improve kidney access. Canadian patients will benefit from this project in multiple ways. New forms of training and continuing education will lead to better clinical outcomes, fewer side effects and reduced clinical stays. More efficient PCNL may allow centres to offer same-day surgery, potentially saving millions of dollars annually to the Canadian healthcare system. The results of this collaboration will enable Marion Surgical to further establish itself as a leader in VR for healthcare and hire as many as 5 engineers in the next 5 years to advance the results of this collaboration in Canada.