NOVEMBER 2023 25 Improved PCNL with Computer Vision Computer Vision News which is simpler. When the needle is inserted in the kidney, the surgeon may be assisted by fluoroscopic guidance to perform the best possible needle insertion - the right angle and the tracking of the needle during the insertion; when ultrasound guidance is preferred to avoid radiations, some more dexterity is required from the surgeon, since less of the anatomy is visible. At the end of the procedure, the surgeon might choose a tubeless or fully tubeless solution, which avoid the insertion of a catheter to serve as a drain (nephrostome) for a few days. This procedure is quite common and successful. It is possible though to improve it. In particular, we suggest to improve the access part of PCNL. Access is one of the most challenging parts of the procedure, and we believe that dramatic improvements can be made by integrating artificial intelligence solutions combined with hardware. This will procure better outcomes and easier procedures even for less experienced surgeons. Less punctures will be needed since the number of incorrect accesses, involving removing the needle and puncturing again, will be much lower. Less punctures lead to less complications in the way. The surgeon must choose very carefully the access route for the needle. How can we ask computer vision and AI to improve this choice? The first improvement is in the
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