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Planning thoracoscopic segmentectomies with 3-dimensional reconstruction software improves outcomes.

Aljaz Hojski1, Mohamed Hassan1, Makhmudbek Mallaev1

  • 1Department of Thoracic Surgery, University Hospital Basel, Basel, Switzerland.

Interdisciplinary Cardiovascular and Thoracic Surgery
|March 21, 2025
PubMed
Summary

Preoperative 3D models improve lung surgery outcomes. Planning complex video-assisted thoracoscopic surgery (VATS) segmentectomies with 3D models reduces thoracotomy conversions and severe complications, enhancing patient safety.

Keywords:
3D-reconstructionVATS segmentectomycomplicationconversionsurgical outcome

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Area of Science:

  • Thoracic Surgery
  • Medical Imaging
  • Surgical Planning

Background:

  • Video-assisted thoracoscopic surgery (VATS) segmentectomies are increasingly common.
  • Accurate preoperative anatomical understanding is crucial for VATS success.
  • 3D reconstruction software offers detailed visualization of lung anatomy.

Purpose of the Study:

  • To evaluate if 3D models generated from CT scans improve surgical and postoperative outcomes in VATS segmentectomies.
  • To compare outcomes of VATS segmentectomies performed with and without 3D model-assisted planning.
  • To assess the impact of 3D models on complication rates and surgical procedures.

Main Methods:

  • Retrospective analysis of 100 VATS segmentectomies (2018-2023).
  • Comparison of outcomes between surgeries planned with 3D models versus those without.
  • Propensity modeling and inverse probability of treatment weighting (IPTW) for data analysis.

Main Results:

  • 3D model group showed more complex segmentectomies (89% vs 38%) and fewer thoracotomy conversions (P=0.003).
  • IPTW analysis revealed significantly fewer severe complications (Clavien-Dindo grade III/IV) (OR 0.10, P=0.037).
  • No Clavien-Dindo grade V complications occurred in the 3D model group.

Conclusions:

  • Preoperative 3D models significantly reduce thoracotomy conversions and postoperative complications in complex VATS segmentectomies.
  • 3D model-assisted planning enables safe performance of complex anatomical resections.
  • This technology enhances the safety and efficacy of VATS segmentectomies.