Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance
IntroductionAbdominal computed tomography (CT) can accurately demonstrate organs and vascular structures around the stomach, and its potential role for image guidance is becoming increasingly established. However, solely using two-dimensional CT images to identify critical anatomical structures is u...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1140175/full |
| _version_ | 1797901711308750848 |
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| author | Sung Hyun Park Sung Hyun Park Ki-Yoon Kim Ki-Yoon Kim Yoo Min Kim Yoo Min Kim Woo Jin Hyung Woo Jin Hyung Woo Jin Hyung |
| author_facet | Sung Hyun Park Sung Hyun Park Ki-Yoon Kim Ki-Yoon Kim Yoo Min Kim Yoo Min Kim Woo Jin Hyung Woo Jin Hyung Woo Jin Hyung |
| author_sort | Sung Hyun Park |
| collection | DOAJ |
| description | IntroductionAbdominal computed tomography (CT) can accurately demonstrate organs and vascular structures around the stomach, and its potential role for image guidance is becoming increasingly established. However, solely using two-dimensional CT images to identify critical anatomical structures is undeniably challenging and not surgeon-friendly. To validate the feasibility of a patient-specific 3-D surgical navigation system for preoperative planning and intraoperative guidance during robotic gastric cancer surgery.Materials and methodsA prospective single-arm open-label observational study was conducted. Thirty participants underwent robotic distal gastrectomy for gastric cancer using a virtual surgical navigation system that provides patient-specific 3-D anatomical information with a pneumoperitoneum model using preoperative CT-angiography. Turnaround time and the accuracy of detecting vascular anatomy with its variations were measured, and perioperative outcomes were compared with a control group after propensity-score matching during the same study period.ResultsAmong 36 registered patients, 6 were excluded from the study. Patient-specific 3-D anatomy reconstruction was successfully implemented without any problems in all 30 patients using preoperative CT. All vessels encountered during gastric cancer surgery were successfully reconstructed, and all vascular origins and variations were identical to operative findings. The operative data and short-term outcomes between the experimental and control group were comparable. The experimental group showed shorter anesthesia time (218.6 min vs. 230.3 min; P=0.299), operative time (177.1 min vs. 193.9 min; P=0.137), and console time (129.3 min vs. 147.4 min; P=0.101) than the control group, although the differences were not statistically significant.ConclusionsPatient-specific 3-D surgical navigation system for robotic gastrectomy for gastric cancer is clinically feasible and applicable with an acceptable turnaround time. This system enables patient-specific preoperative planning and intraoperative navigation by visualizing all the anatomy required for gastrectomy in 3-D models without any error.Clinical trial registrationClinicaltrials.gov, identifier NCT05039333. |
| first_indexed | 2024-04-10T09:06:11Z |
| format | Article |
| id | doaj.art-0d49182d104c4776bde25dbc75fa0468 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T09:06:11Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-0d49182d104c4776bde25dbc75fa04682023-02-21T07:16:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-02-011310.3389/fonc.2023.11401751140175Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidanceSung Hyun Park0Sung Hyun Park1Ki-Yoon Kim2Ki-Yoon Kim3Yoo Min Kim4Yoo Min Kim5Woo Jin Hyung6Woo Jin Hyung7Woo Jin Hyung8Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of KoreaGastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of KoreaDepartment of Surgery, Yonsei University College of Medicine, Seoul, Republic of KoreaGastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of KoreaDepartment of Surgery, Yonsei University College of Medicine, Seoul, Republic of KoreaGastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of KoreaDepartment of Surgery, Yonsei University College of Medicine, Seoul, Republic of KoreaGastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Republic of KoreaVision AI, Hutom, Seoul, Republic of KoreaIntroductionAbdominal computed tomography (CT) can accurately demonstrate organs and vascular structures around the stomach, and its potential role for image guidance is becoming increasingly established. However, solely using two-dimensional CT images to identify critical anatomical structures is undeniably challenging and not surgeon-friendly. To validate the feasibility of a patient-specific 3-D surgical navigation system for preoperative planning and intraoperative guidance during robotic gastric cancer surgery.Materials and methodsA prospective single-arm open-label observational study was conducted. Thirty participants underwent robotic distal gastrectomy for gastric cancer using a virtual surgical navigation system that provides patient-specific 3-D anatomical information with a pneumoperitoneum model using preoperative CT-angiography. Turnaround time and the accuracy of detecting vascular anatomy with its variations were measured, and perioperative outcomes were compared with a control group after propensity-score matching during the same study period.ResultsAmong 36 registered patients, 6 were excluded from the study. Patient-specific 3-D anatomy reconstruction was successfully implemented without any problems in all 30 patients using preoperative CT. All vessels encountered during gastric cancer surgery were successfully reconstructed, and all vascular origins and variations were identical to operative findings. The operative data and short-term outcomes between the experimental and control group were comparable. The experimental group showed shorter anesthesia time (218.6 min vs. 230.3 min; P=0.299), operative time (177.1 min vs. 193.9 min; P=0.137), and console time (129.3 min vs. 147.4 min; P=0.101) than the control group, although the differences were not statistically significant.ConclusionsPatient-specific 3-D surgical navigation system for robotic gastrectomy for gastric cancer is clinically feasible and applicable with an acceptable turnaround time. This system enables patient-specific preoperative planning and intraoperative navigation by visualizing all the anatomy required for gastrectomy in 3-D models without any error.Clinical trial registrationClinicaltrials.gov, identifier NCT05039333.https://www.frontiersin.org/articles/10.3389/fonc.2023.1140175/fullsurgical navigationgastric cancerrobotic gastrectomyimage-guided surgerypatient-specific 3-D model |
| spellingShingle | Sung Hyun Park Sung Hyun Park Ki-Yoon Kim Ki-Yoon Kim Yoo Min Kim Yoo Min Kim Woo Jin Hyung Woo Jin Hyung Woo Jin Hyung Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance Frontiers in Oncology surgical navigation gastric cancer robotic gastrectomy image-guided surgery patient-specific 3-D model |
| title | Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance |
| title_full | Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance |
| title_fullStr | Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance |
| title_full_unstemmed | Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance |
| title_short | Patient-specific virtual three-dimensional surgical navigation for gastric cancer surgery: A prospective study for preoperative planning and intraoperative guidance |
| title_sort | patient specific virtual three dimensional surgical navigation for gastric cancer surgery a prospective study for preoperative planning and intraoperative guidance |
| topic | surgical navigation gastric cancer robotic gastrectomy image-guided surgery patient-specific 3-D model |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1140175/full |
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