Abstract：【Objective】To explore the value of augmented reality combined with laparoscopy in the resection of hepatocelluar carcinoma. 【Methods】The 3D virtual model of liver cancer patients was constructed with the data obtained by MRI before operation. The 3D image and the image collected by laparoscope were transferred to the video acquisition card of workstation, and the synthetic video was sent to the video display of operating room through workstation processing. Finally, AR construction was completed and the liver tumor was removed with AR. 【Results】The 3D image of liver cancer constructed before operation and the liver image collected during laparoscopic operation are processed by workstation to achieve accurate fusion. The liver tumor was located in the posterior lobe of the right liver, about 5 cm×5 cm. The texture of the tumor was hard, and the boundary was not clear. No metastasis was found in the abdominal cavity and pelvic cavity. The operation time was about 180 minutes, and the hilum of liver was blocked four times during the operation, each time was 15 minutes, the interval was 5 minutes, and the amount of bleeding was about 300 ml. On the day 1, the stomach tube was pulled out and the fluid was fed. On the day 2, the patient got out of bed and had exhaust. On the day 5, the abdominal drainage tube was pulled out. On the day 7, the patient was discharged smoothly. 【Conclusion】The combination of AR and laparoscopy can accurately fuse the image obtained by laparoscopy with the 3D model before operation in real time, so as to guide laparoscopy to carry out accurate resection of liver tumor.
谢威, 罗嘉, 陈攀, 康忠诚, 吴飞跃, 石磊. 增强现实技术引导腹腔镜在肝癌切除术中的应用价值[J]. 医学临床研究, 2019, 36(12): 2367-2369.
XIE Wei, LUO Jia, CHEN Pan, et al. Application Value of Augmented Reality Guided Laparoscopy in Hepatectomy (A Case Report). JOURNAL OF CLINICAL RESEARCH, 2019, 36(12): 2367-2369.
[1] Reich H, Mcglynn F, Decaprio J,et al. Laparoscopic excision of benign liver lesions[J].Obstet Gynecol,1991,78(5 Pt 2):956-958. [2] Descottes B, Lachachi F, Sodji M, et al. Early experience with laparoscopic approach for solid liver tumors: initial 16 cases[J].Ann Surg,2000,232(5):641-645. [3] Biertho L, Waage A, Gagner M. Laparoscopic hepatectomy[J].Ann Chir,2002,127(3):164-170. [4] 程钧,李汛. 腹腔镜肝切除治疗肝癌的应用进展[J].西部医学,2014(02):263-265. [5] 董家鸿,叶晟.开启精准肝胆外科的新时代[J].中华普外科手术学杂志(电子版),2016,10(3):181-184. [6] 朱明,柴岗,张艳,等. 基于增强现实的下颌角截骨配准技术的研究[J].上海口腔医学,2010,29(6):571-574. [7] Mikhail M, Mithani K, Ibrahim GM. Presurgical and intraoperative augmented reality in neuro-oncologic surgery: clinical experiences and limitations[J].World Neurosurg,2019,128:268-276. [8] Wong K, Yee H M, Xavier B A, et al. Applications of augmented reality in otolaryngology: a systematic review[J].Otolaryngol Head Neck Surg,2018,159(6):956-967. [9] 石磊,罗涛,张理,等. HoloLens眼镜在肝癌切除手术中的初步应用[J].中南大学学报(医学版),2018,43(05):500-504. [10] Kenngott H G, Wagner M, Gondan M, et al. Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging[J].Surg Endosc,2014,28(3):933-940.
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