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R. Miyazaki

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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-023 - Direct projection of three dimensional volume analyzed CT images to the surgical field by the portable digital light processing projector for assisting minimally invasive thoracic surgery (ID 1910)

      09:30 - 16:30  |  Author(s): R. Miyazaki

      • Abstract

      Video-assisted thoracoscopic surgery (VATS) has been applied widely to thoracic surgery such as VATS lobectomy, resection of chest wall/ mediastinal tumors. The appropriate placement of trocar is the keys for these procedures. Many surgeons places the first -port to look inside of the thoracic cavity by thoracoscope, and determine the position of the other ports. However, there are differences in deformation and the thickness of the thorax of individual patients. In this study, we analyzed the adequate surgical approach by analyzing the three dimensional Computed tomography (3D-CT), and develop the prototype system to project the 3D-CT image to the patient body directly to mark the points of surgical approach.

      3D-CT based minimally invasive surgery was designed using 3D-CT volume analyzer Synapse Vincent (Fuji film, Japan). Skin window, skeletal structure, intra-thoracic anatomical images were reconstructed respectively. The designed points of trocar were marked in 3D-CT image of skin window and projected on the patinet’s body by a liquid projector. Positional / magnification power correction was made using the land marks such as sternal notch, bilateral nipples, costal arch, and acromion. The error of the system was evaluated using artificial thorax model. Two chest wall tumor patients and 2 mediastinal tumor patients were enrolled for the clinical study. Each surgical incision was planned based on the system. The system validity was evaluated by 3 surgeons.

      The error of liquid projector guided skin marking was within 9.3 ± 2.5mm in the distance of 15 cm the center of projection point using artificial thorax model. 3D-CT based surgical approach were prospectively planned and the position of skin incisions were marked on the patients’ body by the liquid projector which projecting the position of the trocars determined by 3D-CT simulations. In the clinical study, Each skin incision made on the point indicated by the liquid projector were placed in the adequate position.

      Direct projection of three dimensional volume analyzed CT images to the surgical field by the portable liquid projector indicated the adequate approaching point on the surgical field for the minimally invasive surgery. This method may present the appropriate surgical approach to thoracic surgeons.