Application of three-dimensional reconstruction with a Hisense computer-assisted system in upper pancreatic lymph node dissection during laparoscopic-assisted radical gastrectomy

• Main Authors: Hao Liu, Feifei Wang, Bo Liu, Ziwen Zheng, Junjiang Zhao, Jian Zhang
• Format: Article
• Language: English
• Published: Elsevier 2021-05-01
• Series: Asian Journal of Surgery
• Subjects: Computer-assisted system; Distal gastrectomy; Lymph node dissection; Pancreas; Reconstruction
• Online Access: http://www.sciencedirect.com/science/article/pii/S1015958421000178

Background/objective: To investigate the feasibility of three-dimensional (3D) reconstruction with an interactive Hisense computer-assisted system (CAS) for preoperative planning and intraoperative guidance during laparoscopic-assisted upper pancreatic lymph node dissection in distal gastrectomy for gastric cancer. Methods: This study included 28 patients who underwent preoperative 3D reconstruction of the upper border of the pancreas using Hisense CAS (3D reconstruction group) for preoperative planning and intraoperative navigation. To determine its efficacy, the clinical data of these patients were compared with those of 28 patients who did not undergo 3D reconstruction (control group). Results: Fifty-six cases of laparoscopic-assisted distal gastrectomy were performed. Three-dimensional reconstruction was successful in all the patients in the 3D reconstruction group, and real-time navigation was performed during the operation. The rate of correspondence between the 3D reconstruction images and intraoperative findings was 100%. The time taken for upper pancreatic lymph node dissection, number of upper pancreatic lymph node dissections, and number of unnecessary injuries during surgery were superior in the 3D reconstruction group than in the control group. The results of the remaining parameters were not statistically significant. Conclusion: Preoperative planning with interactive Hisense CAS 3D reconstruction technology can improve surgeons’ understanding of each patient’s individual anatomy and can reveal anatomical variations, which is helpful for accurate preoperative planning and intraoperative navigation. This technique is helpful for the implementation of the precise dissection of lymph nodes at the upper edge of the pancreas and improves the quality and safety of the surgery.