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Yan QF, Yang W, Ma JM, Zhaxiyundan, Chen YZ, Tang R. Mixed reality technology improves liver surgery in lower-volume medical center. Hepatobiliary Pancreat Dis Int 2024:S1499-3872(24)00071-7. [PMID: 38824094 DOI: 10.1016/j.hbpd.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/14/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Qi-Fu Yan
- General Surgery Department, Lhasa People's Hospital, Tibet Autonomous Region, Lhasa 850000, China
| | - Wei Yang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology (Chinese Ministry of Education), School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Jian-Ming Ma
- General Surgery Department, Lhasa People's Hospital, Tibet Autonomous Region, Lhasa 850000, China
| | - Zhaxiyundan
- General Surgery Department, Lhasa People's Hospital, Tibet Autonomous Region, Lhasa 850000, China
| | - Yong-Zhi Chen
- General Surgery Department, Lhasa People's Hospital, Tibet Autonomous Region, Lhasa 850000, China
| | - Rui Tang
- General Surgery Department, Lhasa People's Hospital, Tibet Autonomous Region, Lhasa 850000, China; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Key Laboratory of Digital Intelligence Hepatology (Chinese Ministry of Education), School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
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Fichtl A, Sheikhani A, Wagner M, Kleger A, Müller M, Sturm N, Walter B, Franz AM. Implementing an electromagnetic tracking navigation system improves the precision of endoscopic transgastric necrosectomy in an ex vivo model. Sci Rep 2024; 14:10055. [PMID: 38698058 PMCID: PMC11066121 DOI: 10.1038/s41598-024-60647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
Endoscopic transgastric necrosectomy is crucial in the management of complications resulting from necrotizing pancreatitis. However, both real-time and visual-spatial information is lacking during the procedure, thereby jeopardizing a precise positioning of the endoscope. We conducted a proof-of-concept study with the aim of overcoming these technical difficulties. For this purpose, a three-dimensional (3D) phantom of a stomach and pancreatic necroses was 3D-printed based on spatial information from individual patient CT scans and subsequently integrated into a silicone torso. An electromagnetic (EM) sensor was adjusted inside the endoscope´s working channel. A software interface enabled real time visualization. The accuracy of this novel assistant system was tested ex vivo by four experienced interventional endoscopists who were supposed to reach seven targets inside the phantom in six different experimental runs of simulated endoscopic transgastric necrosectomy. Supported by endoscopic camera view combined with real-time 3D visualization, all endoscopists reached the targets with a targeting error ranging between 2.6 and 6.5 mm in a maximum of eight minutes. In summary, the EM tracking system might increase efficacy and safety of endoscopic transgastric necrosectomy at the experimental level by enhancing visualization. Yet, a broader feasibility study and further technical improvements are mandatory before aiming at implementation into clinical setting.
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Affiliation(s)
- Anna Fichtl
- Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
- Endoscopic Research Unit, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Alaan Sheikhani
- Institute for Medical Engineering and Mechatronics, University of Applied Sciences Ulm, Albert-Einstein-Allee 53-55, 89081, Ulm, Germany
| | - Martin Wagner
- Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Alexander Kleger
- Institute of Molecular Oncology and Stem Cell Biology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
- Division of Interdisciplinary Pancreatology, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Martin Müller
- Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Niklas Sturm
- Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
- Endoscopic Research Unit, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Benjamin Walter
- Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
- Endoscopic Research Unit, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Alfred Michael Franz
- Institute for Medical Engineering and Mechatronics, University of Applied Sciences Ulm, Albert-Einstein-Allee 53-55, 89081, Ulm, Germany
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
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Rayar M, Levi Sandri GB. The importance of preoperative imaging in living-donor hepatectomy. Hepatobiliary Surg Nutr 2024; 13:356-358. [PMID: 38617489 PMCID: PMC11007347 DOI: 10.21037/hbsn-24-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Michel Rayar
- Service de Chirurgie Hépatobiliaire et Digestif, Centre Hospitalier Universitaire de Rennes, Rennes, France
- NuMeCan Institute (Nutrition, Metabolisms and Cancer), Inserm, INRAE, Univ Rennes 1, Rennes, France
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Liu J, Xiu W, Lin A, Duan G, Jiang N, Wang B, Wang F, Dong Q, Xia N. Can Hisense computer-assisted surgery system (Hisense CAS) improve anatomy teaching in pediatric liver surgery? Surg Radiol Anat 2024; 46:117-124. [PMID: 38189912 DOI: 10.1007/s00276-023-03277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE This study aimed to investigate the effectiveness of the Hisense computer-assisted surgery system (CAS) in teaching pediatric liver surgical anatomy. METHODS The research subjects were residents who underwent standardized training at the Department of Pediatric Surgery at Yijishan Hospital of Wannan Medical College from May 2022 to May 2023. RESULTS The study recruited a total of 62 students, with 31 students assigned to the Hisense CAS group (12 males and 19 females) and the remaining 31 students serving as controls (Control group, 15 males and 16 females). There were no significant differences in baseline characteristics observed between the two groups. This study found that the average scores of the Hisense CAS teaching group in the liver surgery evaluations were higher than those of the control group. Specifically, the Hisense CAS group had an average score of 84.25 ± 5.70 points in the liver surgery knowledge test, 77.10 ± 8.12 points in the image reading test, and 70.58 ± 8.79 points in the surgical simulation test, while the traditional teaching group had average scores of 73.45 ± 6.12 points, 69.81 ± 6.05 points, and 66.42 ± 6.61 points, respectively; the differences between the two groups were statistically significant (P < 0.05). Furthermore, this study also found that the Hisense CAS teaching model resulted in significantly better teaching satisfaction on the part of the residents in terms of standardized teaching for physicians in pediatric liver surgical anatomy. CONCLUSION In conclusion, this study demonstrated greater satisfaction of the residents with the use of 3D reconstruction added to traditional teaching sessions and better performance during the posttraining evaluation.
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Affiliation(s)
- Jie Liu
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China
- Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, Qingdao University, No. 308, Ningxia Road, Shinan District, Qingdao, 266071, Shandong, China
| | - Wenli Xiu
- Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, Qingdao University, No. 308, Ningxia Road, Shinan District, Qingdao, 266071, Shandong, China
- Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, No. 16, Jiangsu Road, Shinan District, Qingdao, 266000, Shandong, China
| | - Aiqin Lin
- Department of Medical Biology of Wannan Medical College, Wannan Medical College, Wuhu, 241002, China
| | - Guangqi Duan
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China
| | - Nannan Jiang
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China
| | - Bao Wang
- Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China
| | - Feifei Wang
- Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, Qingdao University, No. 308, Ningxia Road, Shinan District, Qingdao, 266071, Shandong, China.
- Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, No. 16, Jiangsu Road, Shinan District, Qingdao, 266000, Shandong, China.
- Shandong Provincial Key Laboratory of Digital Medicine and Computer-Assisted Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
| | - Qian Dong
- Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, Qingdao University, No. 308, Ningxia Road, Shinan District, Qingdao, 266071, Shandong, China.
- Department of Pediatric Surgery, Affiliated Hospital of Qingdao University, Qingdao University, No. 16, Jiangsu Road, Shinan District, Qingdao, 266000, Shandong, China.
| | - Nan Xia
- Institute of Digital Medicine and Computer-Assisted Surgery of Qingdao University, Qingdao University, No. 308, Ningxia Road, Shinan District, Qingdao, 266071, Shandong, China.
- Shandong Provincial Key Laboratory of Digital Medicine and Computer-Assisted Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China.
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