Computational FEM Application on Percutaneous Nephrolithotomy (PCNL) Minimum Invasive Surgery Through Needle Insertion Process

Introduction

Accurate needle insertion into the kidney is an essential and challenging step for successful nephrolithotomy process (Lahme et al., 2001) (Pelit et al., 2017). Numerous plans and surgical performances have been improved to effortlessly attain the appropriate renal approach (Kirac et al., 2013) (Resorlu et al., 2013). Surgical needle placing is very significant in medical surgical area and particularly in ‘Urology’ as it covers huge area of renal stone surgery (Kim et al., 2020) (Srisubat et al., 2009) (Yuri et al., 2018) (Cabrera et al., 2020). It will help enormously in faultless the puncture in to the kidney for the duration of percutaneous nephrolithotomy process. Apart from applied force, density of the soft tissue, numerous other factors like needle tip shape (whether beveled or diamond), tip sharpness, strength of the shaft of needle and angle of needle in respect to tissue in heterogeneous tissue will impact on velocity of needle (Saussine et al., 2008). Nephrolithiasis is an important universal source of morbidity; comprises a regular urological syndrome which involves between 15% of the world population, with a following clinical reversion rate of around 50%. Modern techniques and surgical progresses have substitute they require for conventional surgery (open) with minimum invasive techniques, for example extracorporeal shockwave lithotripsy and percutaneous nephrolithotomy (Atassi et al., 2020). The choice of the exact renal stone surgical practice typically depends on the stones’ shape and size, material composition (Wilhelm et al., 2015), and position of the calculi, the continuation of distal urinary difficulties, and anatomic dissimilarity of the urinary structure (Kumar et al., 2012) (Sabnis et al., 2014). Nowadays, nephrolithotomy is the recognized process for removaing of the ‘Staghorn renal stone’ (Desai et al., 2017) (Wang et al., 2020) (Gadzhiey et al., 2020) (Aminsharifi et al., 2016). The surgical process usually involves with three most important phases, initially with the placing of a ureteral catheter to execute a retrospective study to estimate the anatomy of the kidney and to decide whether a renal stone is jamming the urinary tract (Raharia et al., 2019) (Fu et al., 2017). After that, the minimal insertion is done by a surgical needle from the skin en route for the exact calculi position (He et al., 2015). Presently medical science and engineering going hand in hand, different engineering applications are making medical science more advanced, like Virtual reality (VR)/Augmented Reality (AR), image processing, biorobotics etc. [Barua et al., 2022]. Figure 1 shows the percutaneous nephrolithotomy (PCNL) process. The ultimate process concerns the disintegration and extraction renal stone via surgical apparatus, for example forceps, nephroscope, baskets, and lithotripters (Di Grazia et al., 2013) (Giusti et al., 2020) (Choudhury et al., 2021) (Lipsky et al., 2013). The most common problems were bleeding (7.8%), hydrothorax (1.8%), and perforation of renal pelvis (3.4%), blood transfusion (5.7%), and fever (10.5%) (Kallidonis et al., 2016) (De et al., 2015) (Nikić et al., 2014). The success rate and treatment results of the operation are extremely well recognized as being greatly dependent on the exactness and precision of the insertion step, as it have to attain the calculi through an accurate and precise path, which is making this phase the main challenging assignment for surgeons (Ichaoui et al., 2019) (Sourial et al., 2019) (Bozzini et al., 2020).