Document Detail


Three-dimensional surgical simulation-guided navigation in thoracic surgery: a new approach to improve results in chest wall resection and reconstruction for malignant diseases.
MedLine Citation:
PMID:  24144806     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Oncological surgery of the chest wall should be performed to achieve free margins of at least 2 cm for metastasis or 4 cm for primary tumours. When the lesion is not visible or palpable, difficulty in identification may lead to a larger incision and a resection wider than is necessary.
METHODS: We report three cases of non-palpable metastatic chest wall lesions in which the preoperative surgical planning and the intraoperative identification of the tumour, and thus the subsequent chest wall reconstruction, was supported using computer-based surgery.
RESULTS: The application of high-resolution three-dimensional imaging technology and navigational systems is used in preoperative surgical planning to provide virtual simulations of a patient's skeletal changes and new soft tissue profile. Intraoperatively, a mobile navigation probe was used to identify the lesion, matching surgical landmarks and the preoperative computed tomography imaging, achieving the radical resection of the tumour with correct but not excessive surgical margins. Two patients underwent partial sternectomy followed by sternal allograft reconstruction. The third patient underwent chest wall resection followed by reconstruction using titanium bars and vicryl mesh. In all cases, the postoperative period was uneventful. After a follow-up period of 13.9 and 8 months, respectively, all patients are disease free, without complications.
CONCLUSIONS: Application of navigation technology in thoracic surgery should be encouraged because it is easy to use and requires a limited learning curve.
Authors:
Franco Stella; Giampiero Dolci; Andrea Dell'amore; Giovanni Badiali; Massimo De Matteis; Nizar Asadi; Claudio Marchetti; Alessandro Bini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-20
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  -     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Thoracic Surgery Unit, S. Orsola-Malpighi University Hospital, Bologna, Italy.
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