Department of Endoscopic Surgery, Yotsuya Medical Cube, Tokyo, Japan.
Innovation Lab, Okinaga Research Institute, Teikyo University, Tokyo, Japan.
Surgery. 2022 Apr;171(4):1006-1013. doi: 10.1016/j.surg.2021.10.004. Epub 2021 Nov 1.
Mixed-reality technology, a new digital holographic image technology, is used to present 3-dimensional (3D) images in the surgical space using a wearable mixed-reality device. This study aimed to assess the safety and efficacy of laparoscopic cholecystectomy using a holography-guided navigation system as an intraoperative support image.In this prospective observational study, 27 patients with cholelithiasis or mild cholecystitis underwent laparoscopic cholecystectomy between April 2020 and November 2020. Nine patients underwent laparoscopic cholecystectomy with 3D models generated by a wearable mixed-reality device (laparoscopic cholecystectomy with 3D models) and 18 underwent laparoscopic cholecystectomy with conventional two-dimensional images (laparoscopic cholecystectomy with 2D images) as surgical support images. Surgical outcomes such as operative time, blood loss, and perioperative complication rate were measured, and a four-item questionnaire was used for subjective assessment. All surgeries were performed by a mid-career and an experienced surgeon.
Median operative times of laparoscopic cholecystectomy with 3-dimensional models and 2-dimensional images were 74.0 and 58.0 minutes, respectively. No intraoperative blood loss or perioperative complications occurred. Although the midcareer surgeon indicated that laparoscopic cholecystectomy with 3-dimensional models was "normal" or "easy" compared with 2-dimensional images in all cases, the experienced surgeon rated 3-dimensional models as more difficult in 3 (33%) of 9 cases.
This study provides evidence that laparoscopic cholecystectomy with 3-dimensional models is feasible. However, the efficacy of laparoscopic cholecystectomy with 3-dimensional models may depend on the surgeon's experience, as indicated by the different ratings provided by the surgeons.
混合现实技术是一种新的数字全息图像技术，使用可穿戴混合现实设备在手术空间中呈现三维（3D）图像。本研究旨在评估全息引导导航系统作为术中辅助图像在腹腔镜胆囊切除术中的安全性和有效性。
在这项前瞻性观察研究中，2020 年 4 月至 2020 年 11 月期间，27 例患有胆石症或轻度胆囊炎的患者接受了腹腔镜胆囊切除术。9 例患者接受了使用可穿戴混合现实设备生成的 3D 模型的腹腔镜胆囊切除术（3D 模型腹腔镜胆囊切除术），18 例患者接受了常规二维图像的腹腔镜胆囊切除术（二维图像腹腔镜胆囊切除术）作为手术支持图像。测量了手术结果，如手术时间、失血量和围手术期并发症发生率，并使用四项问卷进行了主观评估。所有手术均由一位中级和一位经验丰富的外科医生完成。
3D 模型腹腔镜胆囊切除术和二维图像腹腔镜胆囊切除术的中位手术时间分别为 74.0 分钟和 58.0 分钟。术中无出血或围手术期并发症发生。虽然中级外科医生在所有情况下均表示与二维图像相比，3D 模型腹腔镜胆囊切除术“正常”或“容易”，但经验丰富的外科医生在 9 例中的 3 例（33%）中认为 3D 模型更困难。
本研究提供了证据表明，3D 模型腹腔镜胆囊切除术是可行的。然而，3D 模型腹腔镜胆囊切除术的疗效可能取决于外科医生的经验，因为外科医生的评分不同。
