Three-dimensional imaging navigation during a lung segmentectomy using an iPad

• Published in: European journal of cardio-thoracic surgery Vol. 41; no. 4; pp. 893 - 897
• Main Authors: Eguchi, Takashi, Takasuna, Keiichiro, Kitazawa, Atsushi, Fukuzawa, Youhei, Sakaue, Yasuo, Yoshida, Kazuo, Matsubara, Makoto
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-04-2012
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Computers, Handheld; Female; Humans; Imaging, Three-Dimensional - instrumentation; Imaging, Three-Dimensional - methods; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - secondary; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Pneumology; Pneumonectomy - instrumentation; Pneumonectomy - methods; Radiographic Image Interpretation, Computer-Assisted - instrumentation; Radiographic Image Interpretation, Computer-Assisted - methods; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Tomography, X-Ray Computed - methods; Lung segmentectomy; iPad; Three-dimensional imaging; Navigation; Lung; Tridimensional image; Circulatory system; Cardiology; Pneumology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezr127

OBJECTIVES
The requirement for anatomical lung segmentectomies has increased in recent years but this surgical procedure is relatively difficult. We herein present the benefits of using three-dimensional (3D) imaging navigation during a lung segmentectomy via the intra-operative use of an iPad.
METHODS
Fourteen patients who had undergone an anatomic segmentectomy for a primary lung cancer or a metastatic lung tumour between 1 October 2010 and 30 April 2011 were included in this study. Contrast-enhanced scanning was performed twice on each patient, and 3D images were constructed using a workstation. These images were then transferred to an iPad and analysed during the operation using DICOM image viewer software.
RESULTS
The study group included 3 men (21%) and 11 women (79%) ranging in age from 57 to 83 (mean 69 ± 7.8 years). The operative procedure involved a resection in one case each of the right S1, the right S2, the right S2 + S6a, the right S3, the right S6, the left S8 and the left S8 + 9. The left S1 + 2 and the left basal segment were resected in two cases. The left upper division was resected in three cases. All segmentectomies were successful and no major post-operative complications developed in any patient during or after their procedures. No positive margins were detected pathologically.
CONCLUSIONS
A 3D computed tomography navigation using an iPad enhances the ability to perform a safe and secure segmentectomy.