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Related Experiment Video

Updated: Jul 7, 2025

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Three-Dimensional Imaging-Guided Lung Anatomic Segmentectomy: A Single-Center Preliminary Experiment.

Giorgio Cannone1, Vincenzo Verzeletti1, Alberto Busetto1

  • 1Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy.

Medicina (Kaunas, Lithuania)
|December 23, 2023
PubMed
Summary

Video-assisted thoracoscopic surgery (VATS) segmentectomy is complex for early lung cancer. Three-dimensional (3D) CT reconstructions aid surgical planning, improving outcomes and enabling precise anatomical resections.

Keywords:
VATS segmentectomylung cancerthree-dimensional reconstruction

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Medical Imaging

Background:

  • Video-assisted thoracoscopic surgery (VATS) segmentectomy is effective for stage I non-small cell lung cancer (NSCLC).
  • Technical complexity of VATS segmentectomy poses challenges for thoracic surgeons.
  • 3D-CT reconstruction images can assist in surgical planning and execution.

Purpose of the Study:

  • To present personal experience with 11 VATS anatomical resections.
  • To evaluate the utility of 3D reconstructions in pre-operative planning for VATS segmentectomy.
  • To assess outcomes of VATS anatomical resections guided by 3D imaging.

Main Methods:

  • Acquisition of 3D virtual lung models from 1.25 mm 3-phase contrast CT scans.
  • Semi-automatic segmentation of lung parenchyma, airways, and tumors using original CT images.
  • Performance of 11 VATS anatomical resections based on 3D reconstruction planning.

Main Results:

  • Study included 11 patients (6 males, 5 females) with a median lesion diameter of 20 mm.
  • Seven patients had confirmed surgical indications; 3 required lobectomy due to nodal metastasis, 1 due to margins.
  • Average operative time was 142 minutes, median post-operative stay was 6 days, mean closest margin was 13.7 mm.

Conclusions:

  • Image-guided 3D reconstructions are valuable tools for complex VATS resections.
  • 3D imaging aids in sparing healthy lung tissue and achieving disease-free margins.
  • Surgeon experience and skill remain critical for final surgical decisions.