|
Back to 2017 Posters
THE USE OF 3D, MULTI-MODAL VIRTUAL REALITY TECHNOLOGY IN PLANNING AND UNDERTAKING OF A PANCREATIC RESECTION: A CASE REPORT
Sharona Ross*, Darrell Downs, Iswanto Sucandy, Alexander Rosemurgy
Florida Hospital Tampa, Tampa, FL
Introduction
The use of traditional imaging (e.g., CT, MRI) studies are utilized for a variety of clinical applications. However, two-dimensional (2D) images may be cumbersome to interpret for the clinician(s) and difficult to understand for the patient. Traditional imaging can often understate tumor locations and cause difficulty in determining planes between major vasculature (e.g., SMA, SMV, and portal vein). Using traditional (2D) imaging modalities to create three-dimensional virtual reality (3DVR) reconstructions allows patient-specific, virtual reconstructions to assist in case preparation, surgical planning (e.g., neoadjuvant and adjuvant vs. adjuvant therapy) and execution. Herein, we describe our experience with the use of VR technology for case planning, patient education and operative intervention.
Methods
A 63-year old man was referred to our clinic for a pancreatic cyst. Standard 2D imaging from 2014 and 2016 showed a 3cm pancreatic head process cyst. Upon referral, we ordered a triple phase CT of the abdomen, chest, and pelvis which revealed an additional 1.2cm solid mass in the pancreatic body. However, the relationship between the pancreatic body lesion and the local vasculature was poorly visualized. EUS/FNA was undertaken, which confirmed the lesion in the head of the pancreas to be a pancreatic cyst and the lesion in the body of the pancreas as a pancreatic neuroendocrine tumor. The patient’s traditional 2D imaging files were collected and fused to create a 3DVR reconstruction of the patient’s anatomy.
Results
With the assistance of 3DVR, we recommended the patient undergo a robotic pancreaticoduodenectomy. Preoperatively, the virtual model provided 3D visualization of the anatomical relationships between the arteries, veins, pancreatic lesions, and other local anatomy. Immediately prior to operation, the 3DVR was utilized to educate the patient to provide a clear explanation of the surgical plan (i.e., structures to avoid, structures to excise). Intraoperatively, the 3DVR was utilized by the surgical team to navigate the operative field concurrently to provide additional situational awareness. Surgical margins were negative, the patient tolerated the operation well and was discharged on postoperative day four.
Conclusion
A patient-specific 3D virtual reality reconstruction was utilized for a robotic extended pancreaticoduodenctomy. Traditional 2D imaging studies were reconstructed and fused to create a patient-specific, highly detailed virtual model. The 3DVR was utilized preoperatively for patient education and surgical planning and intraoperatively, to assist in surgical navigation. While virtual reality technology shows great promise in pancreatic surgical education and planning, further studies are necessary to detail the impact of the technology on the clinician and patient.
Back to 2017 Posters
|
