Thoracic: Lung: Evolving Technology
Resection Process Map: A novel dynamic simulation system for pulmonary resection

Read at the 99th Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, May 4-7, 2019.
https://doi.org/10.1016/j.jtcvs.2019.07.136Get rights and content
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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.

Graphical abstract

RPM is a novel simulation system for pulmonary resection that generates virtual dynamic images based on patient-specific CT.

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Key Words

surgery simulation
3D reconstruction

Abbreviations and Acronyms

CT
computed tomography
IQR
interquartile range
PA
pulmonary artery
PV
pulmonary vein
RPM
Resection Process Map
STL
stereolithography
3D
3-dimensional
VATS
video-assisted thoracoscopic surgery

Cited by (0)

This work was supported by a grant from the Japan Agency for Medical Research and Development (Acceleration Transformative Research for Medical Innovation, No. 17im0210215).