Augmented Reality Navigation in Open Surgery for Hilar Cholangiocarcinoma Resection with Hemihepatectomy Using Video-based in Situ Three-dimensional Anatomical Modeling: A Case Report

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2017 Sep 15

PMID 28906410

Citations 11

Authors

Rui Tang

Longfei Ma

Canhong Xiang

Xuedong Wang

Ang Li

Hongen Liao

Jiahong Dong

Affiliations

Soon will be listed here.

Abstract

Rationale: Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature.

Patient Concerns: A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks.

Diagnoses: Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma.

Intervention: Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference.

Outcomes: No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results.

Lessons: AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.

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