Three-dimensional imaging navigation during a lung segmentectomy using an iPad

Abstract

Objectives: The requirement for anatomical lung segmentectomies has increased in recent years but this surgical procedure is relatively difficult. We herein present the benefits of using three-dimensional (3D) imaging navigation during a lung segmentectomy via the intra-operative use of an iPad. Methods: Fourteen patients who had undergone an anatomic segmentectomy for a primary lung cancer or a metastatic lung tumour between 1 October 2010 and 30 April 2011 were included in this study.Contrast-enhanced scanning was performed twice on each patient, and 3D images were constructed using a workstation. These images were then transferred to an iPad and analysed during the operation using DICOM image viewer software. Results: The study group included 3 men (21%) and 11 women (79%) ranging in age from 57 to 83 (mean 69 ± 7.8 years). The operative procedure involved a resection in one case each of the right S1, the right S2, the right S2 + S6a, the right S3, the right S6, the left S8 and the left S8 + 9. The left S1 + 2 and the left basal segment were resected in two cases. The left upper division was resected in three cases. All segmentectomies were successful and no major post-operative complications developed in any patient during or after their procedures. No positive margins were detected pathologically. Conclusions: A 3D computed tomography navigation using an iPad enhances the ability to perform a safe and secure segmentectomy. © The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.