Application of computer‐assisted surgery in pediatric mediastinal tumor surgery

Abstract

Background: Computer-assisted Surgery system (CAS) is an effective medical imaging simulation tool, which is widely used in preoperative planning of surgery. The objective of this study is to investigate the clinical application of CAS in pediatric mediastinal tumor resection. Methods: This retrospective study investigated 74 children who underwent mediastinal tumor resection between June 2008 and June 2022 at the pediatric surgical center of the Affiliated Hospital of Qingdao University and Qingdao Women and Children's Hospital. Preoperative chest computed tomography imaging was performed on all children. A total of 44 children (the CAS-assisted group) underwent clinical image 3D reconstruction and preoperative simulation using Hisense CAS.The control group consisted of 30 children who underwent a conventional procedure without CAS. The demographic, preoperative, and complication data were analyzed and compared between the two groups. t-test, Mann-Whitney U test, X 2 test, or Fisher's exact test were used accordingly in this study during analysis. Results:The median operative duration was 119.00 min in the CAS-assisted group and 140.50 min in the control group. The median intraoperative blood loss of the CAS-assisted group and the control group was 14.00 and 31.00 ml respectively.Relative to the control groups, the CAS-assisted group experienced shorter operative duration time (p = 0.041), and less intraoperative blood loss (p < 0.001). The difference in postoperative drain indwelling between the CAS-assisted group (median:4.00 days) and the control group (median:7.00 days) reached a statistical significance (p = 0.001). And the duration of hospitalization after the operation for the CAS-assisted group (median:7.00 days) was shorter than that for the control group (median:9.00 days) (p = 0.001). No significant difference could be found in the rate of blood transfusion (p = 0.258) and the incidence of postoperative complications (p = 0.719) between the two groups. Conclusion:Hisense CAS could effectively assist surgeons to clearly determine the anatomical site of tumors and provide accurate preoperative simulation for surgeons, so as to assist surgeons to specify effective surgical plans for patients.

Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

“…Therefore, as a radiological staging system based on 2D images, the usefulness of this strategy for surgeons is limited, especially when tumors compress the hepatic hilar structure. We propose the use of 3D images to provide a more objective and accurate evaluation of tumor staging and vascular involvement by utilizing 3D spatial position and distance[ 17 - 20 ]. This method is particularly beneficial for patients with multiple tumors, middle lobe involvement, and variations in liver anatomy and has clinical significance.…”

Cholangiocarcinoma identified in perforated choledochal cyst in a 3-year-old boy

“…By analyzing the CT data, this system enables radiation-free examination and facilitates rapid and precise generation of 3D images. Moreover, it allows for adjustment of viewing angles, spatial rotation, and selective concealment of non-relevant organs to bring an anatomical atlas experience, so it's widely used in the treatment of hepatobiliary system diseases in our center [10][11][12]. In this case, we utilized the system to accurately quantify the cyst and gallbladder volumes, identify the correlation between the distal end of the common bile duct and pancreatic duct as well as the variation in the proximal common bile duct, and exclude the presence of adjacent encapsulated abscesses or alterations in the right hepatic artery.…”

Application of Computer-Assisted Surgery System Based on Artificial Intelligence in Pediatric Precise Oncological Surgery

“…This chapter provides a retrospective summary of the key technologies of our self-developed computer-assisted surgery system "Hisense CAS" and analyses its practical application in pediatric oncological surgery, providing individualized computer-assisted surgical planning for common and complex pediatric tumors (such as malignant tumors of the liver, retroperitoneal tumors, and mediastinal tumors) to improve tumor resectability and reduce surgery-related complications [5,6].…”

“…Compared with 2D CT images, 3D reconstructed images can better visualize the adjacent relationships of important mediastinal tissues, whether the tumor invades the blood vessels, and the variations of the blood vessels so that surgeons can clarify the anatomical relationships. Hisense CAS aids in the precise localization of mediastinal tumors and the accurate assessment of important and variant vessels to reduce damage to vital organs and vessels [6,17].…”