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Lin J, Tao H, Wang Z, Chen R, Chen Y, Lin W, Li B, Fang C, Yang J. Augmented reality navigation facilitates laparoscopic removal of foreign body in the pancreas that cause chronic complications. Surg Endosc 2022; 36:6326-6330. [PMID: 35589974 DOI: 10.1007/s00464-022-09195-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Foreign bodies that enter the pancreas and cause chronic complications cannot be removed by endoscopy. Surgical removal is necessary but also challenging. The development of augmented reality navigation has made it possible to accurate intraoperative navigation in laparoscopic surgery. METHODS A 37-year-old female had epigastric pain for 3 months and her abdominal CT showed a linear high-density shadow in her pancreas along with chronic pancreatitis. Three-dimensional models of the liver, pancreas, stomach, blood vessels, and foreign body were created based on CT images. Gastroptosis was found in the three-dimensional models, so surgical approach was adapted to open the hepatogastric ligament to reach the pancreas. After 2-3 s of video images were captured by 3D laparoscopy, a three-dimensional dense stereo-reconstruction method was used to obtain the surface model of pancreas, stomach, and blood vessels. The Globally Optimal Iterative Closest Point method was used to obtain a spatial transformation matrix between the preoperative CT image space and the intraoperative laparoscopic space. Under augmented reality navigation guidance, the position and location of the foreign body were displayed on the surface of the pancreas. Then intraoperative ultrasound was used for further verification and to quickly and easily confirm the surgical entrance. After minimal dissection and removal of the pancreatic parenchyma, the foreign body was removed completely. RESULTS The operation time was 60 min, the estimated blood loss was 10 ml. The foreign body was identified as a 3-cm-long fishbone. The patient recovered without complications and was discharged on the third postoperative day. CONCLUSION Because it enables direct visual navigation via simple operation, ARN facilitates the laparoscopic removal of foreign bodies in the pancreas with accurate and rapid positioning and minimal damage.
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Affiliation(s)
- Jinyu Lin
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Haisu Tao
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.,Hepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhuangxiong Wang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Rui Chen
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Yunlong Chen
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Wenjun Lin
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Baihong Li
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China
| | - Chihua Fang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China. .,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.
| | - Jian Yang
- Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China. .,Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510280, China.
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Png LH, Toh ST, Teo NWY. Transoral endoscopic approach to upper cervical spine migrated foreign bodies. J Laryngol Otol 2021;:1-3. [PMID: 34823613 DOI: 10.1017/S0022215121003765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Migrated ingested foreign bodies in the aerodigestive tract can lodge within vital organs and vessels, causing potentially devastating complications. It is often difficult to localise these foreign bodies, with extrication resulting in the requirement for open approaches which may cause significant morbidity. CASE REPORT This paper presents the case of an ingested migrated stingray bone lodged adjacent to the vertebral artery in the upper cervical spine. This was managed via an endoscopic transoral approach, with the assistance of an image-guidance system. RESULTS Successful extraction of the foreign body was achieved, with minimal residual morbidity. CONCLUSION Our study showed that image-guided endoscopic surgery is a safe, precise and feasible option for the localisation and removal of migrated foreign bodies in the aerodigestive tract involving critical neurovascular structures.
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