Mixed Reality: A Step Further for Planning Complex Renal Tumors (RENAL Nephrometry Score of 7 or Higher).

Mixed reality (MR) technology has emerged in recent years and allows three-dimensional visualization, multiangle observation, remote vision, and virtual-real interaction. This study aims to explore the influence of MR technology on the outcomes and strategy planning of robotic surgery for complex renal tumors. A total of 92 patients with complex renal tumors were enrolled in this study from June 2018 to June 2020. All patients were found to have tumors by magnetic resonance imaging (MRI) in our department. This trial follows CONSORT guidelines and adopts a single-blind parallel design and randomizes patients with a random number table. The study was approved by the institutional review board, and written informed consent was obtained from each participant. All surgeries were performed by three experienced and high-volume surgeons. The demographic indicators, intraoperative and postoperative complications, renal function outcomes, pathological results, and surgical strategies were recorded. Student's -test and Wilcoxon rank-sum test were used to compare continuous variables, and Pearson's chi-squared and Fisher's exact tests were used to compare categorical variables. Warm ischemia time (WIT) mainly comprises tumor resection time and reconstruction time, and the reconstruction time accounts for a larger proportion. For urologists treating complex renal tumors, MR technology can help them reduce the warm ischemia time (21.3 ± 4.0 23.6 ± 5.9 minutes,  = 0.031), reconstruction time (15.4 ± 3.8 17.2 ± 4.2 minutes,  = 0.034), estimated blood loss ( = 0.044), operation time (125.7 ± 26.3 144.6 ± 27.9 minutes,  = 0.001), and intraoperative complications ( = 0.030). MR-assisted surgery can reduce the incidence of intraoperative complications and improve perioperative outcomes, and MR may be a good preoperative tool for planning complex renal tumor surgery.