Usefulness of Virtual 3D image analysis in laparoscopic gastrectomy for trainee surgeons
- VernacularTitle:Дадлагажиж буй мэс засалч нарт дурангаар ходоод тайрах мэс заслын үед 3 хэмжээст зураглал бүхий анализыг ашиглахын ач холбогдол
- Author:
Masaaki Nishi
;
Kozo Yoshikawa
;
Jun Higashijima
;
Takuya Tokunaga
;
Toshihiro Nakao
;
Chie Takasu
;
Shohei Eto
;
Hiroki Teraoku
;
Mistuo Shimada
- Publication Type:journal article
- From:Innovation
2014;8(4):114-115
- CountryMongolia
- Language:English
-
Abstract:
Background: Laparoscopic gastrectomy has several difficult points including,
lymph node dissection and resection of several blood vessels for trainee surgeons.
Recently, preoperative evaluation of vasculature based three-dimensional (3D)
imaging technique resulted in a significantly improved clinical outcome in
abdominal surgery. The aim of this study is to investigate the usefulness of the 3D
image in laparoscopic gastrectomy for trainee surgeons.
Method: We adopted a multiphase CT protocol to acquire 3 image sets (arterial,
portal, and equilibrium phases). 3D-reconstruction of gastric vasculature was
made using data from a contrast enhanced MDCT and SYNAPSE VINCENT
software. Whole pancreas, spleen, gastric vasculature were extracted from MDCT
scans and traced. Thirty three patients, who underwent laparoscopic gastrectomy
for gastric cancer during the period between Jan 2013 and May 2014 were
examined in this study. Four trainees performed a 19 laparoscopic gastrectomy,
while 14 laparoscopic gastrectomy were conducted by the two trainers. The
surgical outcomes in both groups and the pattern of gastric vasculatures were
evaluated.
Result: 3D imaging technique showed a correct positional relationship between
the stomach, gastric vessels, pancreas and spleen. Surgical outcome including
estimated blood loss, and operative time in trainee group were not significantly
different compared to trainer group. 3D imaging technique showed a correct
positional relationship between the stomach, gastric vessels, pancreas and spleen.
Regarding vascular pattern detected by 3D imaging, the origins of IPA were RGEA
in 12 cases (36%), GDA in 8 cases (24%).bifurcation of RGEA and GDA in7 cases
(21%), and not detected in 1 case (3%), respectively. The types of confluence of
IPV were RGEV in 16 cases (48%), ASPDV in 10 cases (30%), and not detected
in 7 cases (21%), respectively.
Conclusions: 3D imaging technique might contribute to successful laparoscopic
gastrectomy. Preoperative 3D-simulation techniques enabled trainee surgeons to
easily and safely perform laparoscopic gastrectomy.
