Le Moal Julien, Peillon Christophe, Dacher Jean-Nicolas, Baste Jean-Marc
Department of Radiology, Rouen University Hospital, Rouen, France.
Department of General and Thoracic Surgery, Rouen University Hospital, Rouen, France.
J Thorac Dis. 2018 Jan;10(1):196-201. doi: 10.21037/jtd.2017.11.144.
The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy.
Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion.
Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique.
We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study.
我们的初步研究目的是评估由Visible Patient™进行的三维(3D)重建是否有助于机器人辅助节段切除术的手术规划、效率及安全性。
在2014年至2015年期间,通过Visible Patient™在线服务提供3D重建,并将其用于机器人节段切除术的手术规划。为获得3D重建,外科医生将患者匿名化的计算机断层扫描(CT)图像上传至安全的Visible Patient™服务器,完成后下载模型。
在2014年至2015年期间,使用术前3D模型进行了9例节段切除术。所有3D重建均符合我们的预期:解剖准确性(支气管、动脉、静脉、肿瘤以及带有肋间间隙的胸壁)、感兴趣叶内各节段的准确界定、切缘切除、自由空间旋转、便携性(智能手机、平板电脑)以及节省时间的技术。
我们已经表明,在我们机器人辅助节段切除术的实践中,使用Visible Patient™重建的3D CT进行手术规划是有用的。主要缺点是成本高昂。其对减少并发症和提高手术效率的影响是一项正在进行的研究的对象。