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Three-dimensional Location Approach with Silk Thread Guided Laparoscopic Segmentectomy for Liver Tumor

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Three-dimensional simulation, surgical navigation and thoracoscopic lung resection.

Masato Kanzaki¹, Takuma Kikkawa², Kei Sakamoto²

¹Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan kanzaki@twmu.ac.jp.

Journal of Surgical Case Reports

|June 26, 2014

Summary

This study demonstrates 3-dimensional (3-D) video-assisted thoracoscopic surgery using a 3-D navigation system and a patient-specific 3-D pulmonary model. This advanced approach enabled precise bi-subsegmentectomy for a solitary pulmonary nodule.

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Area of Science:

Thoracic Surgery
Medical Imaging
Surgical Navigation

Background:

3-dimensional (3-D) video-assisted thoracoscopic surgery (VATS) offers enhanced visualization.
Preoperative simulation using patient-specific 3-D pulmonary models can improve surgical planning.

Observation:

A 78-year-old male patient presented with a small solitary pulmonary nodule in the left upper lobe.
Chest computed tomography revealed the nodule involved two subsegments (S1 + 2c and S3a).

Findings:

A 3-D video navigation system guided a complete VATS bi-subsegmentectomy with lymph node dissection.
The system utilized a patient-specific 3-D reconstructed pulmonary model for preoperative simulation and intraoperative guidance.
Intraoperative comparison of the 3-D surgical field with the 3-D reconstructed model was performed using a 3-D digital vision system and 3-D glasses.

Implications:

3-D navigation systems and patient-specific models enhance precision in VATS lung resections.
This technology facilitates complex procedures like bi-subsegmentectomy for solitary pulmonary nodules.
Integration of 3-D visualization improves intraoperative accuracy and potentially patient outcomes.