Virtual reality-enabled precision in percutaneous nephrolithotomy - strategic access planning in a malrotated kidney: A case report

Table 1 Summary of published studies evaluating virtual reality-based surgical planning in urology and comparison with the present case

Ref.	Design	VR/3D technology	Clinical context	Key functional advantage	Procedural impact	Clinical relevance
Wake et al[4], 2020	Systematic review	3D printing, AR, VR	General urologic surgery	Enhanced spatial understanding	Not reported	Establishes conceptual framework for 3D/VR utility
Parkhomenko et al[6], 2019	Pilot study	Immersive VR renal models	PCNL planning	Better calyceal orientation recognition	Not reported	Demonstrates feasibility in endourology
Porpiglia et al[5], 2018	Review article	3D virtual models	Preoperative urologic planning	Improved surgical orientation	Not reported	Supports patient-specific planning paradigm
Hosseini et al[8], 2024	Randomized study	3D virtual reconstruction	PCNL access planning	Increased puncture accuracy	Not reported	Provides comparative evidence vs fluoroscopy
Present case, 2026	Case report	Patient-specific immersive VR (CT DICOM-based)	PCNL in malrotated kidney	Precise calyx selection & tract planning	Operative time: 42 minutes. Fluoroscopy: 52 seconds	Demonstrates real-world application in complex anatomy with optimal outcomes

AR: Augmented reality; 3D: Three dimensional; VR: Virtual reality; PCNL: Percutaneous nephrolithotomy; CT: Computed tomography.