Novel Intraoperative Augmented Reality-Guided Specimen Localization in Chest Wall Oncologic Surgery: A Case Report

Area of Science:

• Oncologic Surgery
• Medical Imaging
• Augmented Reality

Background:

• Surgical margin localization is challenging in oncologic surgery, especially during staged reconstruction due to anatomical landmark distortion.
• Accurate margin assessment is crucial for preventing recurrence in cancer surgery.

Purpose of the Study:

• To evaluate the feasibility of using augmented reality (AR) to reorient a 3D tumor model within the resection bed during staged chest wall reconstruction.
• To assess AR's compatibility with surgical workflows and its potential to improve margin localization.

Main Methods:

• A proof-of-concept case report involving a patient with recurrent chest wall sarcoma.
• Specimen resection followed by 3D scanning to create a digital twin.
• Virtual annotation of the 3D model and uploading to an Apple Vision Pro (AVP) AR headset for intraoperative use.
• AR-guided reorientation of the holographic model using anatomical landmarks.

Main Results:

• AR-guided reorientation of the specimen-derived 3D model was feasible in staged chest wall reconstruction.
• First-time AR users successfully manipulated and positioned the model after brief onboarding.
• AR integration did not alter routine care or delay operative workflow (5 min onboarding, 5 min placement/verification).
• Qualitative confirmation of alignment was achieved using inked specimen surfaces and rib orientation.

Conclusions:

• Augmented reality-guided reorientation of specimen-derived 3D models is feasible and compatible with surgical workflows in reconstructive chest wall surgery.
• This technology holds potential for improving surgical precision and margin assessment in complex oncologic cases.