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Updated: Jan 13, 2026
Mixed Reality Assisted Radical Endoscopic Thyroidectomy
Published on: January 31, 2025
Three-Dimensional Reconstruction and Extended Reality in Thoracic Surgery: Japanese Expert Recommendations From the
Yujin Kudo1, Daisuke Asano2, Satoshi Kobayashi3
1Department of Surgery, Tokyo Medical University, Tokyo, Japan.
Introduction:
Precise spatial understanding of the bronchovascular tree is essential for anatomical lung resection. Three-dimensional (3D) reconstruction and extended-reality (XR) technologies have emerged as tools for preoperative planning, navigation, and education. We aimed to assess the current use and efficacy of 3D and XR technologies in thoracic surgery in Japan and develop expert recommendations.
Methods:
Two clinical survey questions on the usefulness of 3D imaging in thoracic surgery and that of VR, AR, and MR were sent to 125 certified thoracic surgical centers. PubMed searches targeted thoracic 3D and XR studies, including English-language randomized, prospective, and retrospective studies, systematic reviews, and meta-analyses. Draft statements were refined at the Anatomy on the Border Expert Consensus Meeting (Japan Society for Endoscopic Surgery 2024).
Results:
Fifty of the 125 institutions (40%) responded. 3D imaging was used by 96% of the institutions, and 72% used it in all cases. "Very" or "moderately" useful was reported by 94% of the institutions. Main purposes for using 3D imaging were preoperative simulation (84%) and anatomical understanding (86%); 52% of the institutions used 3D imaging for intraoperative reference. For XR, awareness was moderate, but adoption remained limited (8%). Among respondents, 74% rated its usefulness as uncertain, while only a small proportion found it clearly useful for preoperative simulation, intraoperative localization, and education. Literature search showed that 3D-planning reduces blood loss, operative time, and complications in segmentectomy, whereas XR studies demonstrated improved nodule localization and workflow efficiency.
Conclusions:
3D imaging should be the standard for complex thoracic resections, particularly segmentectomy. XR is a promising tool, with broader deployment expected as its usability improves and cost decreases.
