混合现实技术在肺结节术前讨论及术中应用的研究

Mixed reality technique in preoperative discussion and intraoperative pulmonary nodules surgery

目的介绍混合现实技术在肺结节术前和术中的应用。方法以1例两肺多发结节的49岁女性患者最终行单孔胸腔镜下左肺下叶背段切除及左肺上叶楔形切除术为例。利用Mimics医学图像后处理软件,根据患者术前胸部CT影像DICOM数据重建患者肺部影像。将三维重建的影像数据导入HoloLens眼镜,在混合现实技术辅助下进行术前讨论制定手术方式、和患者进行术前谈话,同时在术中利用混合现实技术实时导航辅助手术。结果混合现实技术清晰预显示血管、气管、病灶等重要解剖结构以及相互位置关系。在混合现实技术辅助下手术进行顺利,总手术时间49 min,精准背段切除时间27 min,术中出血量约39 mL。患者术后恢复良好顺利出院。结论混合现实技术在肺结节术前及术中有一定的应用价值,该技术的不断成熟和在临床工作中进一步应用将为胸外科发展带来新方向的同时也提供更广阔的前景。

Objective To introduce the application of mixed reality technique to the preoperative and intraoperative pulmonary nodules surgery.Methods One 49-year female patient with multiple nodules in both lobes of the lung who finally underwent uniportal thoracoscopic resection of superior segment of left lower lobe and wedge resection of left upper lobe was taken as an example.The Mimics medical image post-processing software was used to reconstruct the patient’s lung image based on the DICOM data of the patient’s chest CT image before the surgery.The three-dimensional reconstructed image data was imported into the HoloLens glasses,and the preoperative discussions were conducted with the assistance of mixed reality technology to formulate the surgical methods,and the preoperative conversation with the patients was also conducted.At the same time,mixed reality technology was used to guide the surgery in real time.Results Mixed reality technology can clearly pre-show the important anatomical structures of blood vessels,trachea,lesions and their positional relationship.With the help of mixed reality technology,the operation went smoothly.The total operation time was 49 min,the precise dorsal resection time was 27 min,and the intraoperative blood loss was about 39 mL.The patient recovered well and was discharged from hospital smoothly after surgery.Conclusion Mixed reality technology has certain application value before and during the surgery for pulmonary nodules.The continuous maturity of this technology and its further application in clinics will not only bring a new direction to the development of thoracic surgery,but also provide a wide prospect.