Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Interact Cardiovasc Thorac Surg. 2022 May 2;34(5):808-813. doi: 10.1093/icvts/ivab379.
Recently, preoperative and intraoperative simulation using three-dimensional computed tomography (CT) has attracted much attention in thoracic surgery. However, because conventional three-dimensional CT only shows static images, dynamic simulation is required for a more precise operation. We previously reported on a resection process map for pulmonary resection, which we developed to generate virtual dynamic images from preoperative patient-specific CT scans. The goal of this study was to evaluate the feasibility of the clinical use of the resection process map for anatomical lung resection.
This study included 5 lobectomies for different lobes and 4 representative segmentectomies. Dissection of the pulmonary arteries, veins and bronchi were considered key parts of each procedure. To assess the description of images obtained from the resection process map, relevant clips from the actual surgical videos were collected, retrospectively replicated and superimposed on the resection process map to explain the procedures.
In all surgical procedures, the resection process map successfully and semiautomatically generated a virtual dynamic image from the patient-specific CT data. Moreover, superimposition of the virtual images on the selected clips from the surgical videos showed no major differences.
The resection process map could generate virtual images that corresponded to the actual surgical videos and has the potential for clinical use as preoperative and intraoperative simulation.
最近,使用三维计算机断层扫描(CT)进行术前和术中模拟在胸外科中受到了广泛关注。然而,由于传统的三维 CT 仅显示静态图像,因此需要进行动态模拟以实现更精确的手术。我们之前曾报告过一种用于肺切除术的切除过程图,该图是为了从术前患者特定的 CT 扫描中生成虚拟动态图像而开发的。本研究的目的是评估切除过程图在解剖性肺切除中的临床应用的可行性。
本研究包括 5 例不同肺叶的肺叶切除术和 4 例有代表性的节段切除术。肺动脉、静脉和支气管的解剖被认为是每个手术的关键部分。为了评估从切除过程图获得的图像描述的可行性,从实际手术视频中收集了相关剪辑,进行回顾性复制,并将其叠加到切除过程图上以解释手术过程。
在所有手术过程中,切除过程图均成功地从患者特定的 CT 数据半自动生成了虚拟动态图像。此外,虚拟图像与手术视频中的选定剪辑的叠加显示没有明显差异。
切除过程图可以生成与实际手术视频相对应的虚拟图像,具有作为术前和术中模拟的临床应用潜力。