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Essential Surgical Plan Modifications After Virtual Reality Planning in 50 Consecutive Segmentectomies.

Wouter Bakhuis¹, Amir H Sadeghi¹, Iris Moes¹

¹Department of Cardiothoracic Surgery, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.

The Annals of Thoracic Surgery

|September 9, 2022

Summary

Three-dimensional virtual reality (VR) planning for pulmonary segmentectomy significantly altered surgical plans in 52% of cases, leading to a 98% radical resection rate and improved anatomical insight.

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Area of Science:

Thoracic Surgery
Medical Imaging
Virtual Reality Applications

Background:

Pulmonary segmentectomy is gaining interest, but identifying segmental borders on 2D CT scans is challenging.
Preoperative virtual reality (VR) offers enhanced visualization of patient-specific anatomy.
3D VR technology aims to improve surgical planning for pulmonary segmentectomies.

Purpose of the Study:

To evaluate the added clinical value of 3D VR (PulmoVR) in preoperative planning for pulmonary segmentectomy.
To assess the impact of VR on surgical plan modifications and resection outcomes.

Main Methods:

Fifty patients undergoing pulmonary segmentectomy were included.
CT scans were segmented to create 3D VR models of lung segments, airways, and vasculature.
Surgeons planned procedures using conventional CT and subsequently with VR visualization.

Main Results:

Surgical plans were modified in 52% of cases after VR visualization.
Tumor location adjustments (14%), lung-sparing resections (10%), and extended segmentectomies (28%) were noted.
Pathologic examination confirmed radical resection in 98% of patients.

Conclusions:

3D VR technology demonstrated significant added clinical value in pulmonary segmentectomy planning.
VR visualization improved understanding of patient-specific bronchovascular anatomy.
The technology facilitated more precise, lung-sparing resections with high rates of radical tumor removal.