Julien Le Moal, Christophe Peillon, Jean-Nicolas Dacher, Jean-Marc Baste
Institution : Service de chirurgie générale et thoracique, hôpital Charles-Nicolle, Rouen
Objectives : The objective of our pilot study was to assess if three-dimensional reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy.
Methods : Between 2014 and 2015, three-dimensional reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain three-dimensional reconstruction, the surgeon uploaded the anonymized computed tomography image of the patient to the secured Visible Patient™ server and then downloaded the model after completion.
Results : Nine segmentectomies were performed between 2014 and 2015 using a pre-operative three-dimensional model. All three-dimensional reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique.
Conclusion : We have shown that operative planning by three-dimensional computed tomography using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. A larger study is warranted to confirm the utility of three-dimensional computed tomography reconstruction for operative planning and its effect on reducing surgical complications and improving efficiency.