Resection Process Map: A novel dynamic simulation system for pulmonary resection

Tokuno, Junko, Chen-Yoshikawa, Toyofumi F., Nakao, Megumi, Matsuda, Tetsuya, Date, Hiroshi

Objective: Use of 3-dimensional computed tomography for preoperative and intraoperative simulation has been introduced in the field of thoracic surgery. However, 3-dimensional computed tomography provides only static simulation, which is a significant limitation of surgical simulation. Dynamic simulation, reflecting the intraoperative deformation of the lung, has not been developed. The aim of this study was to develop a novel simulation system that generates dynamic images based on patient-specific computed tomography data. Methods: We developed an original software, the Resection Process Map, for anatomic pulmonary resection. The Resection Process Map semi-automatically generates virtual dynamic images based on patient-specific computed tomography data. We retrospectively evaluated its accuracy in 18 representative cases by comparing the virtual dynamic images with the actual surgical images. Results: In this study, 9 patients who underwent lobectomy and 9 patients who underwent segmentectomy were included. For each case, a virtual dynamic image was successfully generated semi-automatically by the Resection Process Map. The Resection Process Map accurately delineated 98.6% of vessel branches and all the bronchi. The median time required to obtain the images was 121.3 seconds. Conclusions: We successfully developed a novel dynamic simulation system, the Resection Process Map, for anatomic pulmonary resection.

Resection Process Map: A novel dynamic simulation system for pulmonary resection

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