The Role Of Advanced Imagine And 3d Reconstruction In Robotic Thoracic Surgery For Challenging Cases
Ilaria Ceccarelli1, Gaetano Romano1, Cristina Zirafa1, Katia Cappellini2, Simona Celi2, Federico Davini1, Franca Melfi1.
1University of Pisa, Pisa, Italy, 2Biocardiolab, Fondazione Monasterio, Massa, Italy.
BACKGROUND:In the last years, 3D anatomical model, based on the CT images, allows surgeons to better determine the anatomical relationships between tumor and hilar structures and plays a crucial role in pre-operative surgical planning.The use of this technology can be useful to well define and plan the appropriate surgical procedure in challenging cases, using robotic platforms.METHODS:A sample of three challenging cases in thoracic surgery were selected. All patients have been evaluated with a preoperative CT scan and a 3D reconstruction was performed, using "3D Slicer image computing platform" software, which is a free, open source and multi-platform software package widely used for medical, biomedical, and related imaging research.After the 3D reconstruction, a specific surgical strategy for each case was planned and all the surgical procedures were performed using a fully four-arm Robotic approach. RESULTS:Case 1: patient diagnosed with non-small cell lung cancer (NSCLC) of the right upper lobe suspected to infiltrate the thoracic wall, who underwent neoadjuvant chemo-radiotherapy. The 3D reconstruction has allowed to define the anatomical relationship between the tumor and the Chest Wall and to perform a lobectomy with Robotic technique. Case 2: NSCLC of Right Lung strictly adherent to hilar structures with a suspected infiltration of lower right artery; the reconstruction showed the anatomical relationship between the cancer and the hilar structures and a totally Robotic lower bilobectomy was performed. Case 3: Thymic carcinoma of 8,5 cm of diameter close to the aortic arch with a compression of the main trunk of the pulmonary artery. The 3D reconstruction allowed to plan the procedure so as to perform a complete thymectomy with Robotic approach.
CONCLUSIONS:The application of 3D reconstruction before the surgical approach of complex cases allowed to approach those cases with the Robotic surgery in a safe and feasible way.
Back to 2023 ePosters