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Intraoperative support using mixed reality holograms for hilar and mediastinal lymph node dissection.

Naofumi Miyahara1,2, Masafumi Hiratsuka3,4, Yusuke Okamoto1

  • 1Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga, Saga, 849-0937, Japan.

Surgical Endoscopy
|February 11, 2025
PubMed
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Mixed reality (MR) holograms enhance surgical understanding of thoracic anatomy during hilar and mediastinal lymph node dissection (HMLND). This technology offers a safer, more precise approach to lymph node dissection in lung cancer surgery.

Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Mixed Reality Technology

Background:

  • Accurate lymph node (LN) dissection is critical for lung cancer surgical management.
  • Limited studies address challenges in precise anatomical LN dissection.
  • This study investigates mixed reality (MR) holograms for intraoperative support in hilar and mediastinal lymph node dissection (HMLND).

Purpose of the Study:

  • To evaluate the utility and safety of MR holograms as an intraoperative tool for HMLND.
  • To assess the impact of intraoperative hologram support (IHS) on surgical understanding and precision.

Main Methods:

  • Three-dimensional (3D) holograms of the thoracic cavity were generated from medical images.
  • Holograms were displayed via head-mounted displays (HoloLens2) during HMLND in 10 patients.
Keywords:
Head mount displayHilar and mediastinal lymph nodeHologramIntraoperative simulationLung cancerMixed reality

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  • Safety was assessed, and surgeon utility was evaluated via questionnaire.

    • Main Results:

    • Intraoperative hologram support (IHS) was used for a median of 5 minutes.
    • No 90-day postoperative complications were observed.
    • Surgeons confirmed accurate anatomical representation and greater intraoperative benefit compared to preoperative planning, especially for specific lymph node stations.

    Conclusions:

    • IHS enhances surgical understanding of thoracic anatomy during HMLND.
    • MR holograms have the potential to improve the precision and reliability of lymph node dissection in lung cancer surgery.