选择性夹闭机器人辅助部分肾切除（RAPN）需要广泛的患者肾血管知识，通过影像学获取。为了验证一种内部开发的灌注区域算法，提供患者特定的三维肾脏灌注信息。在2020年10月至2022年6月期间，格恩特大学医院接受RAPN手术的25名患者被纳入研究。基于术前计算机断层扫描（CT）扫描的三维模型显示夹闭动脉的缺血区域，算法计算。所有患者都进行了选择性夹闭手术。术中注射靛绿（ICG）可视化真实的缺血区域。手术记录用于术后分析。通过两个指标比较夹闭动脉的真实缺血区域和算法预测的缺血区域：（1）总的缺血区域重叠和（2）肿瘤缺血区域重叠。六名泌尿科医生评估指标1；指标2由作者客观评估。在92%的情况下，该算法足够准确，可以制定选择性夹闭策略。指标1的平均分数为5分的4.28；指标2的平均分数为5分的4.14。第一个限制是ICG只能评估肾表面。第二个限制是目前主要是肾功能不全的患者可以受益于这项技术，但需要对比增强CT。所提出的新工具在规划RAPN选择性夹闭方面表现出高精度。需要进行后续前瞻性研究以确定该工具的临床附加价值。在部分肾切除中，外科医生没有有关特定动脉分支灌注肾肿瘤的信息。我们开发了一种外科医生支持系统，可在三维模型上可视化所有动脉的灌注区域并指示正确的动脉夹闭。在本研究中，我们验证了这个工具。（版权所有© 2023欧洲泌尿外科学协会。出版Elsevier B.V.。未经授权，禁止转载。）

Selective clamping during robot-assisted partial nephrectomy (RAPN) requires extensive knowledge on patient-specific renal vasculature, obtained through imaging.To validate an in-house developed perfusion zone algorithm that provides patient-specific three-dimensional (3D) renal perfusion information.Between October 2020 and June 2022, 25 patients undergoing RAPN at Ghent University Hospital were included. Three-dimensional models, based on preoperative computed tomography (CT) scans, showed the clamped artery's ischemic zone, as calculated by the algorithm.All patients underwent selective clamping during RAPN. Indocyanine green (ICG) was administered to visualize the true ischemic zone perioperatively. Surgery was recorded for a postoperative analysis.The true ischemic zone of the clamped artery was compared with the ischemic zone predicted by the algorithm through two metrics: (1) total ischemic zone overlap and (2) tumor ischemic zone overlap. Six urologists assessed metric 1; metric 2 was assessed objectively by the authors.In 92% of the cases, the algorithm was sufficiently accurate to plan a selective clamping strategy. Metric 1 showed an average score of 4.28 out of 5. Metric 2 showed an average score of 4.14 out of 5. A first limitation is that ICG can be evaluated only at the kidney surface. A second limitation is that mainly patients with impaired renal function are expected to benefit from this technology, but contrast-enhanced CT is required at present.The proposed new tool demonstrated high accuracy when planning selective clamping for RAPN. A follow-up prospective study is needed to determine the tool's clinical added value.In partial nephrectomy, the surgeon has no information on which specific arterial branches perfuse the kidney tumor. We developed a surgeon support system that visualizes the perfusion zones of all arteries on a three-dimensional model and indicates the correct arteries to clamp. In this study, we validate this tool.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.