Üriner Sistem Taş Hastalığında Görüntüleme Yöntemlerinin Evrimi: Yapay Zekâ Destekli Radyoloji Ve 3d Rekonstrüksiyonların Rolü
Özet
Bu bölümde böbrek taşlarının retrograd intrarenal cerrahi (RIRS) ile tedavisinde yeni nesil aspirasyonlu üreteral erişim kılıfları (SUAS) özetlenmektedir. Nephrolithiasis yükü ve <2 cm taşlarda fleksibl üreteroskopinin üstünlükleri sunulduktan sonra, taşsızlık oranlarını sınırlayan başlıca sorunlar; yükselmiş intrarenal basınç (IRP) ve taş tozu ve fragmanlarının yetersiz uzaklaştırılması vurgulandı. Negatif basınçla aktif drenaj sağlayan, sıklıkla yönlendirilebilir uç ve basınç sensörü içeren SUAS; IRP’yi güvenli aralıkta tutar, görselliği iyileştirir, fragman uzaklaştırmasını hızlandırır ve operasyon süresini kısaltabilir. ClearPetra®, FV-UAS®, FANS®, Irriflex®, VACureteral® gibi sistemlerin özellikleri aktarıldı. Preklinik ve klinik veriler; daha yüksek taşsızlık, daha düşük komplikasyon, DJ stent gereksiniminde azalma ve özellikle alt kaliks gibi zor anatomiler ile seçilmiş pediatrik olgularda etkinlik göstermektedir. Bildirilen yan etkiler çoğunlukla hafif düzeydedir. Robotik RIRS ve yapay zekâ/sensör entegrasyonlarıyla basınç, navigasyon ve gerçek zamanlı litotripsi optimizasyonunun mümkün olacağını öngörüldü; SUAS’ın modern endoürolojide yardımcı araçtan temel bileşene evrildiği sonucu çıkarıldı.
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