Resection Process Map: A novel dynamic simulation system for pulmonary resection

J Thorac Cardiovasc Surg. 2020 Mar;159(3):1130-1138. doi: 10.1016/j.jtcvs.2019.07.136. Epub 2019 Sep 13.

Abstract

Objective: Use of 3-dimensional computed tomography for preoperative and intraoperative simulation has been introduced in the field of thoracic surgery. However, 3-dimensional computed tomography provides only static simulation, which is a significant limitation of surgical simulation. Dynamic simulation, reflecting the intraoperative deformation of the lung, has not been developed. The aim of this study was to develop a novel simulation system that generates dynamic images based on patient-specific computed tomography data.

Methods: We developed an original software, the Resection Process Map, for anatomic pulmonary resection. The Resection Process Map semi-automatically generates virtual dynamic images based on patient-specific computed tomography data. We retrospectively evaluated its accuracy in 18 representative cases by comparing the virtual dynamic images with the actual surgical images.

Results: In this study, 9 patients who underwent lobectomy and 9 patients who underwent segmentectomy were included. For each case, a virtual dynamic image was successfully generated semi-automatically by the Resection Process Map. The Resection Process Map accurately delineated 98.6% of vessel branches and all the bronchi. The median time required to obtain the images was 121.3 seconds.

Conclusions: We successfully developed a novel dynamic simulation system, the Resection Process Map, for anatomic pulmonary resection.

Keywords: 3D reconstruction; surgery simulation.

Publication types

  • Comparative Study
  • Webcast

MeSH terms

  • Aged
  • Female
  • Humans
  • Imaging, Three-Dimensional*
  • Lung / diagnostic imaging
  • Lung / surgery*
  • Male
  • Middle Aged
  • Patient-Specific Modeling*
  • Pneumonectomy / methods*
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted*
  • Retrospective Studies
  • Software Design
  • Surgery, Computer-Assisted*
  • Time Factors
  • Tomography, X-Ray Computed*