Application of three-dimensional simulation technique in the thoracoscopic lobectomy / 中国胸心血管外科临床杂志

@#Objective    To analyze the effect of 3D simulation technique in thoracoscopic lobectomy. Methods    From June 2015 to January 2018, 124 patients with left lower lobe resection underwent thoracoscopy with single-port thoracoscopic surgery, including 64 males and 60 females, aged 42–83 years. They were randomly divided into two groups including an experimental group (preoperatively given 3D simulation surgery in 59 patients) and a control group (preoperatively not given 3D simulation surgery in 65 patients). The clinical effect between the two groups was compared. Results    All patients recovered without any death during hospitalization. In the experimental group, the operation time, intraoperative blood loss and postoperative hospital stay were significantly less than those in the control group (P<0.05). There was no significant difference in postoperative drainage volume, and duration of drainage tube retention and analgesic drug usage between the two groups (P>0.05). Conclusion    3D simulation technique for thoracoscopic lobectomy has advantage in short operation time, minor trauma and quick recovery. It has a guiding role in the preoperative planning of lung cancer surgery and is worthy of popularization and application.

Application of virtual simulation surgery in lumbar spinal metastases / 局解手术学杂志

Objective Through the exploration of virtual simulation surgery to find a way to treat lumbar spinal metastases. Methods Based on 64 row spiral CT continuous 2-dimensional images of lumbar segments, normal lumbar vertebral, destruction of disease, abdominal aorta and kidneys were reconstructed by the Mimics software. 3D visualization structure was contemplated by anterior lesions clear, titanium mesh of bone cement support, and posterior pedicle screw fixation. Results The three-dimensional reconstruction distinctly displayed the structures of lumbar and its adjacent organs, and the entire virtual simulation surgery was intuitive. Conclusion The application of virtual simulation surgery ensures more accurate 3D model of lumbar establishment and its adjacent organs, and it provides an objective basis for in-dividualized treatment programs.

Unilateral intraoral vertical ramus osteotomy based on preoperative three-dimensional simulation surgery in a patient with facial asymmetry

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

Accuracy of simulation surgery of Le Fort I osteotomy using optoelectronic tracking navigation system

INTRODUCTION: The aim of this study was to demonstrate that the simulation surgery on rapid prototype (RP) model, which is based on the 3-dimensional computed tomography (3D CT) data taken before surgery, has the same accuracy as traditional orthograthic surgery with an intermediate splint, using an optoelectronic tracking navigation system. MATERIALS AND METHODS: Simulation surgery with the same treatment plan as the Le Fort I osteotomy on the patient was done on a RP model based on the 3D CT data of 12 patients who had undergone a Le Fort I osteotomy in the department of oral and maxillofacial surgery, Seoul National University Dental Hospital. The 12 distances between 4 points on the skull, such as both infraorbital foramen and both supraorbital foramen, and 3 points on maxilla, such as the contact point of both maxillary central incisors and mesiobuccal cuspal tip of both maxillary first molars, were tracked using an optoelectronic tracking navigation system. The distances before surgery were compared to evaluate the accuracy of the RP model and the distance changes of 3D CT image after surgery were compared with those of the RP model after simulation surgery. RESULTS: A paired t-test revealed a significant difference between the distances in the 3D CT image and RP model before surgery.(P<0.0001) On the other hand, Pearson's correlation coefficient, 0.995, revealed a significant positive correlation between the distances.(P<0.0001) There was a significant difference between the change in the distance of the 3D CT image and RP model in before and after surgery.(P<0.05) The Pearson's correlation coefficient was 0.13844, indicating positive correlation.(P<0.1) CONCLUSION: Theses results suggest that the simulation surgery of a Le Fort I osteotomy using an optoelectronic tracking navigation system is relatively accurate in comparing the pre-, and post-operative 3D CT data. Furthermore, the application of an optoelectronic tracking navigation system may be a predictable and efficient method in Le Fort I orthognathic surgery.

Automatic Simulation Surgery Process of the 3D Computed Tomographic Data in the Unilateral Orbital Hypoplasia

Computer-assisted medical imaging has shown tremendous improvements in definition of in vivo anatomy of patients with craniofacial anomalies. In accordance with developments of simulation surgery, preoperative surgical simulation can now be performed more accurately and interactively within the environment of computer graphic workstation and can also provide the best solution for surgery by displaying the 3 dimensional simulation images. The interactive surgical simulation approach is based on digitally osteotomized objects which have been translocated manually by an operator who visually determines the amount of movement required until the desired end result is achieved. However, this approach depends upon subjective assessment and may not consistently provide optimal simulation in all directions due to manual movement of the osteotomized object by mouse or trackball. In addition, this procedure is time and labor intensive due to repetitive processing to obtain a satisfactory end result. This study demonstrates a method of surface matching of digitally osteotomized objects, by simulating the deformed orbit to the assumed ideal position of mirror image without manual manipulation of simulation objects. This process can move the osteotomized object to the preset end results-mirror image- automatically by computer module. The single processing of the osteotomized segment changes the position of simulated segments with certainty. This procedure allows more accurate and reliable result of simulation surgery. However, it will be valuable only when one can determine the ideal end results such as mirror image of this article as a normal template.

Computer Simulation Surgery of the Mandibular Distraction Osteogenesis

Among three directions of distraction, the horizontal direction shows the least displacement of the condyle process and the largest overlapping surface area. We interpreted above result as the horizontal vector was the ideal direction of distraction among three directions in this patient. The mirror image of normal half side can be used as a target object of simulation surgery and also be used for evaluation of the different assumption of the surgical modalities. In conclusion, the computer simulation surgery using the mirrored image in hemifacial deformity can be an effective method for the prediction and the evaluation of the real surgery and also show the new possibility of application to the other computer simulation technology.

Approach on clinical application of visual artificial simulation splenectomy / 解放军医学杂志

Objective To study the three-dimensional (3D) reconstruction of pancreas based on the data of 64-row helical CT scanning and the effect of the dynamic simulation surgery of spleen.Methods The original scan data of spleen 64-slice helical CT were collected and the image program segmentation and automatic extraction were done with images of CT series by adaptive region growing algorithm.Then the image processing software was used to proceed with the 3D reorganization with the images which are segmented.Import reconstructed objectives to FreeForm Modeling System in the form of STL format were embellished and smoothed.GHOST SDK software of FreeForm Modeling System was utilized to develop various instruments needed by simulated surgeries.And the visualization of simulated surgery by PHANTOM software was studied before the splenectomy.Results By the adaptive region growing algorithm, the spleen image procedure could be calculated soon and efficiently, and the satisfactory spleen segmentation data were obtained.The clear picture structure of 3D- reorganization was a exact reproduction of spleen and the structures of vital organs and passages around;The simulated splenectomy was high simulated, vivid, exact and the operator could feel like a real surgery.Conclusions The research of 3D reorganization and visual artificial simulation surgery to spleen with the medical image process software and the FreeForm Modeling System can make surgeons know the 3D anatomical structure around spleen clearly before the surgery.And it is of great help to reduce the risk of surgery, decrease operative complications, and improve the effect of surgery.