Development of 3D-image guiding system for the thoracoscopic surgery.
Pneumothorax with radiologically-detectable bulla was selected as objective disease for this study. This is partly because the target lesions are located on the surface of the lungs, and partly because images of the virtual thoracoscopy derived from half-collapsed lungs most mimic the real thoracoscopic images.MPR images and virtual thoracoscopic images were reconstructed by 3-Dworkstation. The workstation monitor was set next to the thoracoscopic monitor to facilitate the comparison of these two images. Real-time virtual thoracoscopy guiding was performed by an assistant surgeon who reconstructs, moves, and rotates the 3D images of the lung synchronizedly with the real thoracoscopic images. Marks were given to each bulla in the virtual images so as the surgeons easily detect on the real thoracoscopy.
Virtual images gave good simulation to the real thoracoscopic images. Even small bulla was detected under assistance of marking on the virtual image.
We report real-time 3D-image guiding system for the thoracoscopic surgery. This system gives reliable detection of bulla and reduction of operation time. Furthermore, operator could reduce the risk of misidentification of anatomical structure through comparison of real and virtual images.
Endoscopic surgery is accompanied with limited view and lack of perspective. On site real-time computer-guided endoscopic surgery system may be the key to this problem, but introduction of such technology to thoracic surgery has been outstripped in comparison with craniomaxillofacial surgery, cerebral nerve surgery, and orthopedic surgery.
Toshihiko Sato, None.