Application of the Ultraleap 3Di-Based Gesture-Controlled 3D Imaging Visualization System in Pulmonary Segmentectomy:...

Pulmonary segmentectomy serves as a crucial approach for treating early-stage lung cancer. However, this procedure demands precise identification of segmental anatomy, and surgeons often need to repeatedly consult the patient's 3D imaging data or other medical records during the operation. Traditional contact-based intraoperative imaging assistance devices involve cumbersome operation and pose risks to the sterile environment. This study aims to evaluate the clinical utility of an Ultraleap 3Di-based gesture-controlled 3D imaging visualization system for non-contact interaction during pulmonary segmentectomy in patients with early-stage lung cancer.

This study enrolled 58 patients with early-stage non-small cell lung cancer scheduled for video-assisted thoracoscopic pulmonary segmentectomy from June 2025 to December 2025. Participants were randomly assigned to either the experimental group or the control group. Intraoperatively, the experimental group utilized the Ultraleap 3Di system for non-contact 3D image review, while the control group relied on conventional contact-based devices for image retrieval, which was operated by non-sterile assistants. The compared outcomes included intraoperative image retrieval time, total operative time, intraoperative blood loss, R0 resection rate, postoperative drainage duration, and surgeon satisfaction.

The baseline characteristics were comparable between the two groups. The mean age was 53.66 ± 9.12 years in the experimental group and 55.21 ± 8.76 years in the control group (t = -0.66, p > 0.05); the experimental group included 16 males and 13 females, while the control group included 14 males and 15 females (χ² = 0.276, p > 0.05). Preoperative pulmonary function, as measured by FEV1/FVC ratio, was 74.48 ± 4.75% in the experimental group versus 76.08 ± 4.51% in the control group (t = -1.31, p > 0.05). The image retrieval time in the experimental group was significantly shorter than that in the control group (75.16 ± 19.38 s versus 209.59 ± 28.13 s, t = -21.19, p < 0.001, 95% CI [-147.13, -121.72], Cohen's d = -5.57). The total operative time was also reduced (88.72 ± 13.82 min versus 96.55 ± 13.90 min, t = -2.15, p = 0.036, 95% CI [-15.12, -0.53], Cohen's d = -0.57). No significant differences were observed between the two groups in terms of R0 resection rate (both 100%), intraoperative blood loss, or postoperative drainage duration (p > 0.05). The operating surgeons rated the system highly for image clarity, navigation timeliness, and overall utility, while the score for operational convenience was relatively neutral (mean score 3.2).

The Ultraleap 3Di-based non-contact visualization system reduces the time required for intraoperative image retrieval and improves overall procedural efficiency in segmentectomy, without compromising surgical safety or oncological radicality. Future efforts should focus on optimizing the intuitiveness of gesture interaction and exploring its integration with augmented reality and artificial intelligence to further advance the system's intelligence and practical utility.