The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective

Background: The intraoperative localization of nonpalpable pulmonary nodules for thoracoscopic wedge resection is technically challenging. Current preoperative image-guided localization techniques require additional time, costs, procedural risks, advanced facilities, and well-trained operators. In t...

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Main Authors: Zhen Feng, MD, Shuliang Yu, MD, Haixiao Diao, MB, Yue Yu, MB, Zhongmin Peng, MD
Format: Article
Language:English
Published: Elsevier 2023-04-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250722005958
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author Zhen Feng, MD
Shuliang Yu, MD
Haixiao Diao, MB
Yue Yu, MB
Zhongmin Peng, MD
author_facet Zhen Feng, MD
Shuliang Yu, MD
Haixiao Diao, MB
Yue Yu, MB
Zhongmin Peng, MD
author_sort Zhen Feng, MD
collection DOAJ
description Background: The intraoperative localization of nonpalpable pulmonary nodules for thoracoscopic wedge resection is technically challenging. Current preoperative image-guided localization techniques require additional time, costs, procedural risks, advanced facilities, and well-trained operators. In this study, we explored a cost-effective method of well-matched interaction between virtuality and reality for accurate intraoperative localization. Methods: Through the integration of techniques involving preoperative 3-dimensional (3D) reconstruction, temporary clamping of target vessel and the modified inflation-deflation method, the segment on the 3D virtual model and the segment under the thoracoscopic monitor were well matched in the inflated state. Then the spatial relationships of target nodule to the virtual segment could be applied to the actual segment. The well-matched interaction between virtuality and reality would facilitate nodule localization. Results: A total of 53 nodules were successfully localized. The median maximum diameter of the nodules was 9.0 mm (interquartile range [IQR], 7.0-12.5 mm). The median depthmin and depthmax were 10.0 mm and 18.2 mm, respectively. The median macroscopic resection margin was 16 mm (IQR, 7.0-12.5 mm). The median duration of chest tube drainage was 27 hours, with a median total drainage of 170 mL. The median postoperative length of hospital stay was 2 days. Conclusions: The well-matched interaction between virtuality and reality is safe and feasible for intraoperative localization of nonpalpable pulmonary nodules. It may be proposed as a preferred alternative to traditional localization methods.
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spelling doaj-art-a67fe9c46aaa4f2bb81b1f6cf46704e92025-08-20T03:04:53ZengElsevierJTCVS Techniques2666-25072023-04-011813013610.1016/j.xjtc.2022.11.015The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspectiveZhen Feng, MD0Shuliang Yu, MD1Haixiao Diao, MB2Yue Yu, MB3Zhongmin Peng, MD4Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Province, ChinaDepartment of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Province, ChinaDepartment of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Province, ChinaDepartment of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Province, ChinaDepartment of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Province, China; Address for reprints: Zhongmin Peng, MD, Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jing 10 Rd, Jinan 250000, China.Background: The intraoperative localization of nonpalpable pulmonary nodules for thoracoscopic wedge resection is technically challenging. Current preoperative image-guided localization techniques require additional time, costs, procedural risks, advanced facilities, and well-trained operators. In this study, we explored a cost-effective method of well-matched interaction between virtuality and reality for accurate intraoperative localization. Methods: Through the integration of techniques involving preoperative 3-dimensional (3D) reconstruction, temporary clamping of target vessel and the modified inflation-deflation method, the segment on the 3D virtual model and the segment under the thoracoscopic monitor were well matched in the inflated state. Then the spatial relationships of target nodule to the virtual segment could be applied to the actual segment. The well-matched interaction between virtuality and reality would facilitate nodule localization. Results: A total of 53 nodules were successfully localized. The median maximum diameter of the nodules was 9.0 mm (interquartile range [IQR], 7.0-12.5 mm). The median depthmin and depthmax were 10.0 mm and 18.2 mm, respectively. The median macroscopic resection margin was 16 mm (IQR, 7.0-12.5 mm). The median duration of chest tube drainage was 27 hours, with a median total drainage of 170 mL. The median postoperative length of hospital stay was 2 days. Conclusions: The well-matched interaction between virtuality and reality is safe and feasible for intraoperative localization of nonpalpable pulmonary nodules. It may be proposed as a preferred alternative to traditional localization methods.http://www.sciencedirect.com/science/article/pii/S2666250722005958intraoperative localizationthoracoscopic wedge resectionthree-dimensional reconstructionvirtuality-reality interaction
spellingShingle Zhen Feng, MD
Shuliang Yu, MD
Haixiao Diao, MB
Yue Yu, MB
Zhongmin Peng, MD
The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
JTCVS Techniques
intraoperative localization
thoracoscopic wedge resection
three-dimensional reconstruction
virtuality-reality interaction
title The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
title_full The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
title_fullStr The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
title_full_unstemmed The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
title_short The well-matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulesCentral MessagePerspective
title_sort well matched interaction between virtuality and reality for intraoperative localization of nonpalpable pulmonary nodulescentral messageperspective
topic intraoperative localization
thoracoscopic wedge resection
three-dimensional reconstruction
virtuality-reality interaction
url http://www.sciencedirect.com/science/article/pii/S2666250722005958
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