Mixed reality technique in preoperative discussion and intraoperative pulmonary nodules surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Zihao , HUANG Kenan , DING Xinyu , WEI Rongqiang , LIU Chengdong , XU Zhifei ,  TANG Hua

Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, P.R.China;

Corresponding author：

TANG Hua, Email: tanghua999@smmu.edu.cn

Keywords：

Mixed reality; three-dimensional; lung nodules; thoracoscope

DOI：

10.7507/1007-4848.202002081

Video：

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Objective To introduce the application of mixed reality technique to the preoperative and intraoperative pulmonary nodules surgery.Methods One 49-year female patient with multiple nodules in both lobes of the lung who finally underwent uniportal thoracoscopic resection of superior segment of left lower lobe and wedge resection of left upper lobe was taken as an example. The Mimics medical image post-processing software was used to reconstruct the patient's lung image based on the DICOM data of the patient's chest CT image before the surgery. The three-dimensional reconstructed image data was imported into the HoloLens glasses, and the preoperative discussions were conducted with the assistance of mixed reality technology to formulate the surgical methods, and the preoperative conversation with the patients was also conducted. At the same time, mixed reality technology was used to guide the surgery in real time.Results Mixed reality technology can clearly pre-show the important anatomical structures of blood vessels, trachea, lesions and their positional relationship. With the help of mixed reality technology, the operation went smoothly. The total operation time was 49 min, the precise dorsal resection time was 27 min, and the intraoperative blood loss was about 39 mL. The patient recovered well and was discharged from hospital smoothly after surgery.Conclusion Mixed reality technology has certain application value before and during the surgery for pulmonary nodules. The continuous maturity of this technology and its further application in clinics will not only bring a new direction to the development of thoracic surgery, but also provide a wide prospect.

Citation： CHEN Zihao, HUANG Kenan, DING Xinyu, WEI Rongqiang, LIU Chengdong, XU Zhifei, TANG Hua. Mixed reality technique in preoperative discussion and intraoperative pulmonary nodules surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 797-801. doi: 10.7507/1007-4848.202002081 Copy

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10.	仲晨曦, 谷志涛, 方文涛, 等. 34 例肺单纯性磨玻璃样病灶的临床分析. 上海交通大学学报(医学版), 2011, 31(3): 378-380.
11.	Nomori H, Shiraishi A, Cong Y, et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg, 2018, 53(3): 640-647.
12.	张艳娇, 高禹舜, 毛友生, 等. 胸腔镜解剖性肺段切除术治疗ⅠA期非小细胞肺癌对肺功能的影响. 肿瘤学杂志, 2016, 22(5): 389-393.
13.	刘嘉. 有效医患沟通防范医疗纠纷分析. 临床检验杂志(电子版), 2019, 8(2): 40-41.
14.	Chuah JH, Lok B, Black E. Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills. IEEE Trans Vis Comput Graph, 2013, 19(4): 539-546.
15.	McJunkin JL, Jiramongkolchai P, Chung W, et al. Development of a mixed reality platform for lateral skull base anatomy. Otol Neurotol, 2018, 39(10): e1137-e1142.
16.	Zhang JT, Zhang T, Qiu ZW, et al. Metal-marked mixed reality technology for pulmonary nodule localization. Interact Cardiovasc Thorac Surg, 2019, 29(3): 494.

1. 刘成武,刘伦旭. 肺癌微创外科治疗进展. 中华胸部外科电子杂志, 2016, 3(2): 65-69.
2. 嵇振岭. 当代微创外科前沿和热点问题. 手术, 2016, 1(3): 1-5, 28.
3. 宋德胜, 于在诚, 胡旭, 等. 单向式全胸腔镜肺癌根治术探讨. 中华腔镜外科杂志(电子版), 2014, 7(6): 3-5.
4. Sun R, Aldunate RG, Sosnoff JJ. The validity of a mixed reality-based automated functional mobility assessment. Sensors (Basel), 2019, 19(9): E2183.
5. 罗伟, 王燕一, 侯霞, 等. 混合现实技术常见应用场景. 中华老年口腔医学杂志, 2019, 17(1): 55-58.
6. Lee SC, Fuerst B, Tateno K, et al. Multi-modal imaging, model-based tracking, and mixed reality visualisation for orthopaedic surgery. Healthc Technol Lett, 2017, 4(5): 168-173.
7. Nguyen TH, Qui TC, Xu K, et al. Real-time 3D human capture system for mixed-reality art and entertainment. IEEE Trans Vis Comput Graph, 2005, 11(6): 706-721.
8. 李云婧, 李宬润, 马永富, 等. 虚拟现实导航技术在胸腔镜下肺段切除中的临床应用. 中华肺部疾病杂志(电子版), 2017, 10(4): 461-464.
9. Ameis A, Randhawa K, Yu H, et al. The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities. Eur Spine J, 2018, 27(Suppl 6): 861-869.
10. 仲晨曦, 谷志涛, 方文涛, 等. 34 例肺单纯性磨玻璃样病灶的临床分析. 上海交通大学学报(医学版), 2011, 31(3): 378-380.
11. Nomori H, Shiraishi A, Cong Y, et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg, 2018, 53(3): 640-647.
12. 张艳娇, 高禹舜, 毛友生, 等. 胸腔镜解剖性肺段切除术治疗ⅠA期非小细胞肺癌对肺功能的影响. 肿瘤学杂志, 2016, 22(5): 389-393.
13. 刘嘉. 有效医患沟通防范医疗纠纷分析. 临床检验杂志(电子版), 2019, 8(2): 40-41.
14. Chuah JH, Lok B, Black E. Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills. IEEE Trans Vis Comput Graph, 2013, 19(4): 539-546.
15. McJunkin JL, Jiramongkolchai P, Chung W, et al. Development of a mixed reality platform for lateral skull base anatomy. Otol Neurotol, 2018, 39(10): e1137-e1142.
16. Zhang JT, Zhang T, Qiu ZW, et al. Metal-marked mixed reality technology for pulmonary nodule localization. Interact Cardiovasc Thorac Surg, 2019, 29(3): 494.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Mixed reality technique in preoperative discussion and intraoperative pulmonary nodules surgery

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