Sampogna Gianluca, Pugliese Raffaele, Elli Marco, Vanzulli Angelo, Forgione Antonello
a Department of Biomedical and Clinical Sciences 'L. Sacco' , Università degli Studi di Milano , Milan , Italy.
b Advanced International Mini-invasive Surgery (AIMS) Academy, Ospedale Niguarda Ca' Granda , Milan , Italy.
Minim Invasive Ther Allied Technol. 2017 Jun;26(3):135-143. doi: 10.1080/13645706.2016.1275016. Epub 2017 Jan 13.
The advantages of 3D reconstruction, immersive virtual reality (VR) and 3D printing in abdominal surgery have been enunciated for many years, but still today their application in routine clinical practice is almost nil. We investigate their feasibility, user appreciation and clinical impact.
Fifteen patients undergoing pancreatic, hepatic or renal surgery were studied realizing a 3D reconstruction of target anatomy. Then, an immersive VR environment was developed to import 3D models, and some details of the 3D scene were printed. All the phases of our workflow employed open-source software and low-cost hardware, easily implementable by other surgical services. A qualitative evaluation of the three approaches was performed by 20 surgeons, who filled in a specific questionnaire regarding a clinical case for each organ considered.
Preoperative surgical planning and intraoperative guidance was feasible for all patients included in the study. The vast majority of surgeons interviewed scored their quality and usefulness as very good.
Despite extra time, costs and efforts necessary to implement these systems, the benefits shown by the analysis of questionnaires recommend to invest more resources to train physicians to adopt these technologies routinely, even if further and larger studies are still mandatory.
三维重建、沉浸式虚拟现实（VR）和3D打印在腹部手术中的优势已被阐述多年，但时至今日，它们在常规临床实践中的应用几乎为零。我们研究了它们的可行性、用户认可度及临床影响。
对15例接受胰腺、肝脏或肾脏手术的患者进行研究，实现目标解剖结构的三维重建。然后，开发了一个沉浸式VR环境来导入三维模型，并打印了三维场景的一些细节。我们工作流程的所有阶段均采用开源软件和低成本硬件，其他外科科室可轻松实现。20名外科医生对这三种方法进行了定性评估，他们针对每个所考虑器官的一个临床病例填写了一份特定问卷。
对纳入研究的所有患者而言，术前手术规划和术中指导是可行的。绝大多数接受访谈的外科医生将其质量和实用性评为非常好。
尽管实施这些系统需要额外的时间、成本和精力，但问卷调查分析显示的益处建议投入更多资源来培训医生常规采用这些技术，即便仍需进一步开展更大规模的研究。
