Department of Gastroenterological Surgery, Gifu University Graduate School of Medicine, Gifu, 501-1194, Japan.
Medical Education Development Center, Gifu University, Gifu, Japan.
World J Surg Oncol. 2022 Feb 27;20(1):56. doi: 10.1186/s12957-022-02532-2.
Even if 3D angiographic images of preoperative contrast-enhanced computed tomography (CT) are created, the coronal and axial sections can be unclear, and thus, it is difficult to achieve projection awareness similar to that of actual laparoscopic images. In recent years, the technology of analyzing and applying medical images has advanced, and surgical simulation and navigation have been widely used to improve the safety of surgical operations. It is important to understand pelvic anatomy in the area of rectal cancer, and use of the SYNAPSE VINCENT makes it possible to simulate the anatomy before surgery, which is very useful in educating surgeons and their assistants.
An important objective in surgery is to understand the anatomy of the external/internal iliac arteries and lymph nodes in lateral lymph node dissection (LLD) for rectal cancer. In this study, we explored the accuracy and usefulness of SYNAPSE VINCENT images of pelvic anatomy (especially vascular anatomy) analyzed preoperatively in two cases of LLD for rectal cancer in our department.
The patients were two men aged 73 and 57 years, respectively. Both patients underwent robotic abdominal perineal resection and LLD with neoadjuvant chemoradiotherapy. The operating times for LLD were 138 and 106 min, estimated blood loss was less than 10 mL and 20 mL, and the harvested lymph nodes were nos. 21 and 22, respectively. The SYNAPSE VINCENT could be used for simulation and navigation before and during surgery. For experienced surgeons, the system helped them carry out operations more accurately.
In the future, surgical support using virtual reality, augmented reality, and mixed reality based on medical images will be useful and is expected to improve the safety, accuracy, and efficiency of surgery, which is extremely useful for both young and skilled surgeons preparing for difficult operations.
即使术前增强 CT 生成了 3D 血管造影图像，冠状位和轴位图像也可能不清晰，因此难以获得类似于实际腹腔镜图像的投影意识。近年来，分析和应用医学图像的技术已经取得了进步，手术模拟和导航已经得到广泛应用，以提高手术的安全性。了解直肠癌区域的骨盆解剖结构非常重要，使用 SYNAPSE VINCENT 可以模拟手术前的解剖结构，这对于教育外科医生及其助手非常有用。
手术的一个重要目标是了解直肠癌侧方淋巴结清扫术（LLD）中外侧髂内动脉和淋巴结的解剖结构。在这项研究中，我们探讨了术前分析 SYNAPSE VINCENT 对我们科室两例直肠癌 LLD 患者骨盆解剖结构（特别是血管解剖结构）的准确性和实用性。
患者为两名男性，年龄分别为 73 岁和 57 岁。两名患者均接受了机器人经腹会阴联合切除术和 LLD 联合新辅助放化疗。LLD 的手术时间分别为 138 分钟和 106 分钟，估计出血量分别小于 10 毫升和 20 毫升，采集的淋巴结分别为 21 个和 22 个。SYNAPSE VINCENT 可用于手术前后的模拟和导航。对于有经验的外科医生来说，该系统有助于他们更准确地进行手术。
未来，基于医学图像的虚拟现实、增强现实和混合现实手术支持将是有用的，并有望提高手术的安全性、准确性和效率，这对于准备进行困难手术的年轻和熟练外科医生都非常有用。
