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Novel Thoracoscopic Navigation System With Augmented Real-Time Image Guidance for Chest Wall Tumors.

Authors
 Chang Young Lee  ;  Harley Chan  ;  Hideki Ujiie  ;  Kosuke Fujino  ;  Tomonari Kinoshita  ;  Jonathan C. Irish  ;  Kazuhiro Yasufuku 
Citation
 Annals of Thoracic Surgery, Vol.106(5) : 1468-1475, 2018 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2018
Abstract
BACKGROUND: We developed a thoracoscopic surgical navigation system with real-time augmented image guidance to assess the potential benefits for minimally invasive resection of chest wall tumors. The accuracy of localization of tumor and resection margin and the effect on task workload and confidence were evaluated in a chest wall tumor phantom. METHODS: After scanning a realistic tumor phantom by cone-beam computed tomography and registering the data into the system, three-dimensional contoured tumor and resection margin was displayed. Fifteen surgeons were asked to localize the tumor margin and surgical margins with the thoracoscope alone. The same procedure was performed with the surgical navigation system activated, and results were compared between each attempt. A questionnaire and National Aeronautics and Space Administration Task Load Index were completed after. RESULTS: The surgical navigation system significantly reduced localization error for the medial (p = 0.002) and superior tumor margin (p < 0.001), which was difficult to visualize by thoracoscopy alone. All surgical resection margins were improved circumferentially, including margins that were readily visible by thoracoscopy. National Aeronautics and Space Administration Task Load Index response scores showed a statistically significant reduction in workload in all subscales. There was a more than 50% mean reduction in workload for performance (10.1 vs 4.4, p = 0.001) and frustration (13.0 vs 5.4, p = 0.001). CONCLUSIONS: This study showed that the thoracoscopic surgical navigation system providing augmented image guidance decreased tumor localization error for regions difficult to visualize thoracoscopically and also reduced surgical margin error circumferentially, regardless of thoracoscopic visibility. This system also reduced workload and increased surgeon's confidence in localizing challenging chest wall tumors.
Full Text
https://www.sciencedirect.com/science/article/pii/S0003497518311299
DOI
10.1016/j.athoracsur.2018.06.062
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
이창영(Lee, Chang Young)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165453
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