Three-Dimensional Holographic-Guided Robotic Lung Segmentectomy for Deep Pulmonary Nodules: Technique and Initial Results

• Published in: Surgical innovation 2024-12, Vol.31 (6), p.618-621
• Main Authors: Bagan, Patrick, Aissa, Kaouther, Essid, Rime, Azbabay, Wissam, Zaimi, Rym, Dakhil, Bassel
• Format: Article
• Language: English
• Subjects: Aged; Female; Holography - methods; Humans; Imaging, Three-Dimensional - methods; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Male; Middle Aged; Pneumonectomy - instrumentation; Pneumonectomy - methods; Robotic Surgical Procedures - instrumentation; Robotic Surgical Procedures - methods; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Tomography, X-Ray Computed
• ISSN: 1553-3506; 1553-3514; 1553-3514
• DOI: 10.1177/15533506241290069

Background: Diagnosis and treatment of small and isolated lung nodules remain challenging issues. Purpose: The aim of this article is to report the technique of real-time navigation using holographic reconstruction technology combined with a robot assisted thoracic surgery (RATS) platform for lung resection in patients with small deep nodules. Research Design: The pre-surgery 3D planning was based on the chest CT scan. The reconstruction was uploaded to a head-mounted display for real-time navigation during mini invasive robot assisted surgery performed with an open console platform. We evaluated this technique with the success rate of diagnosis, the operative time and the post-operative course. Study Sample: This technique was performed in 6 patients (4 female, mean age 65 years) to date. Results: The precision of the head-mounted display based localization system was effective in all cases without the need of open conversion. The mean diameter of the nodules was 8 mm (6-9). The diagnosis was a lung cancer (n = 5) and tuberculoma (n = 1). The mean operative time was 125 min (100-145). The mean hospital stay was 2.5 days (1-3). Conclusions: In conclusion, the intraoperative navigation using the 3D holographic assistance was an helpful tool for mini invasive RATS lung segmentectomy without the need of preoperative localization.