Thoracoscopic anatomic pulmonary segmentectomy: a 3-dimensional guided imaging system for lung operations

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Pulmonology

Background:

• Accurate localization of solitary pulmonary nodules and ground-glass opacity nodules is crucial for effective surgical planning.
• Traditional imaging methods may have limitations in precisely defining nodule locations within complex lung anatomy.

Purpose of the Study:

• To evaluate the efficacy of the Lung Operation Three-dimensional Imaging System (Xiamen TRONG Technology Co. Ltd) in preoperatively identifying the exact position of pulmonary nodules.
• To assess the software's utility in guiding virtual segmentectomy and subsequent thoracoscopic procedures.

Main Methods:

• Computed tomography (CT) scans (Toshiba Aquilion One 320) of 10 cases with 12 nodules were acquired.
• 3D reconstructions were generated from 0.5 mm thick CT images, with segmentation based on the pulmonary artery system.
• Nodule location was determined by merging 3D images with colored segments for virtual surgical planning.

Main Results:

• Pulmonary artery branches up to Grade 5 were visualized in all cases.
• The software displayed the anatomical relationships of nodules with surrounding arteries, veins, and bronchi.
• All 12 nodules, including deeply located ones, were successfully resected via thoracoscopic anatomic pulmonary segmentectomy guided by the software.

Conclusions:

• The Lung Operation Three-dimensional Imaging System software is a valuable preoperative tool for precise nodule localization in thoracic surgery.
• The software provides essential guidance for virtual planning and execution of surgical procedures, improving outcomes.