Harirpoush Arash, Rakovich George, Kersten-Oertel Marta, Xiao Yiming
Department of Computer Science and Software Engineering Concordia University Quebec Canada.
Maisonneuve Rosemont Hospital University of Montreal Quebec Canada.
Healthc Technol Lett. 2024 Dec 11;11(6):418-426. doi: 10.1049/htl2.12114. eCollection 2024 Dec.
Video-assisted thoracic surgery (VATS) is a minimally invasive approach for treating early-stage non-small-cell lung cancer. Optimal trocar placement during VATS ensures comprehensive access to the thoracic cavity, provides a panoramic endoscopic view, and prevents instrument crowding. While established principles such as the Baseball Diamond Principle (BDP) and Triangle Target Principle (TTP) exist, surgeons mainly rely on experience and patient-specific anatomy for trocar placement, potentially leading to sub-optimal surgical plans that increase operative time and fatigue. To address this, the authors present the first virtual reality (VR)-based pre-operative planning tool with tailored data visualization and interaction designs for efficient and optimal VATS trocar placement, following the established surgical principles and consultation with an experienced surgeon. In the preliminary study, the system's application in right upper lung lobectomy is demonstrated, a common thoracic procedure typically using three trocars. A preliminary user study of the system indicates it is efficient, robust, and user-friendly for planning optimal trocar placement, with a great promise for clinical application while offering potentially valuable insights for the development of other surgical VR systems.
电视辅助胸腔镜手术（VATS）是治疗早期非小细胞肺癌的一种微创方法。VATS期间最佳的套管针放置可确保全面进入胸腔，提供全景内镜视野，并防止器械拥挤。虽然存在诸如棒球菱形原则（BDP）和三角形目标原则（TTP）等既定原则，但外科医生主要依靠经验和患者特定的解剖结构来进行套管针放置，这可能导致手术计划欠佳，从而增加手术时间和疲劳度。为了解决这个问题，作者提出了首个基于虚拟现实（VR）的术前规划工具，该工具具有量身定制的数据可视化和交互设计，以遵循既定的手术原则并与经验丰富的外科医生协商，实现高效且最佳的VATS套管针放置。在初步研究中，展示了该系统在右上肺叶切除术中的应用，这是一种常见的胸腔手术，通常使用三个套管针。对该系统的初步用户研究表明，它对于规划最佳套管针放置是高效、稳健且用户友好的，具有很大的临床应用前景，同时为其他手术VR系统的开发提供了潜在的有价值见解。
