Essential Surgical Plan Modifications After Virtual Reality Planning in 50 Consecutive Segmentectomies

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)

Abstract

Background: Lately, increased interest in pulmonary segmentectomy has been observed. Segmental border identification is extremely difficult on 2-dimensional computed tomography (CT). Preoperative application of virtual reality (VR) can provide better insight into patient-specific anatomy. The aim of this study was to investigate the added clinical value of 3-dimensional (3D) VR using PulmoVR for preoperative planning. Methods: Patients with an indication for pulmonary segmentectomy were included between June 2020 and September 2021 at the Erasmus Medical Center, Rotterdam, The Netherlands. CT scans were (semi)automatically segmented to visualize lung segments, segmental arteries, veins, and bronchi. Three surgeons made a surgical plan on the basis of the conventional CT scan and subsequently analyzed the VR visualization. The primary outcome was the incidence of critical (ensuring radical resection) preoperative plan modifications. Secondarily, data on observed anatomic variation and perioperative (oncologic) outcomes were collected. Results: A total of 50 patients (median age at surgery, 65 years [interquartile range, 17.25 years]) with an indication for pulmonary segmentectomy were included. After supplemental VR visualization, the surgical plan was adjusted in 52%; the tumor was localized in a different segment in 14%, more lung-sparing resection was planned in 10%, and extended segmentectomy, including 1 lobectomy, was planned in 28%. Pathologic examination confirmed radical resection in 49 patients (98%). Conclusions: This 3D VR technology showed added clinical value in the first 50 VR-guided segmentectomies because a 52% change of plan with 98% radical resection was observed. Furthermore, 3D VR visualization of the bronchovasculature, including various anatomic variations, provided better insight into patient-specific anatomy and offered lung-sparing possibilities with more certainty.

Original languageEnglish
Pages (from-to)1247-1255
Number of pages9
JournalAnnals of Thoracic Surgery
Volume115
Issue number5
Early online date6 Sept 2022
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
This work was supported by Koers23 grant, Erasmus Medical Center , The Netherlands.

Funding Information:
This work was supported by Koers23 grant, Erasmus Medical Center, The Netherlands. Amir H. Sadeghi and Edris A. F. Mahtab are coinventors of the virtual reality–based technology (PulmoVR) presented in this article. All other authors declare that they have no conflicts of interest.

Publisher Copyright:
© 2023 The Society of Thoracic Surgeons

Fingerprint

Dive into the research topics of 'Essential Surgical Plan Modifications After Virtual Reality Planning in 50 Consecutive Segmentectomies'. Together they form a unique fingerprint.

Cite this