scholarly journals Augmented Reality-Assisted Pancreaticoduodenectomy with Superior Mesenteric Vein Resection and Reconstruction

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Rui Tang ◽  
Wei Yang ◽  
Yucheng Hou ◽  
Lihan Yu ◽  
Guangdong Wu ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Tumor Invasion ◽  
Superior Mesenteric Vein ◽  
Splenic Vein ◽  
Smart Phone ◽  
Preoperative Imaging ◽  
3D Images ◽  
Mesenteric Vein ◽  
Computed Tomography Scanning ◽  
Surgical Field

Introduction. Pancreaticoduodenectomy (PD) with superior mesenteric vein (SMV) reconstruction are often required to achieve complete (R0) resection for pancreatic head cancer (PHC) with tumor invasion of the SMV. Augmented reality (AR) technology can be used to assist in determining the extent of SMV involvement by superimposing virtual 3-dimensional (3D) images of the pancreas and regional vasculature on the surgical field. Materials and Methods. Three patients with PHC and tumor invasion of the SMV underwent AR-assisted PD with SMV resection and reconstruction following preoperative computed tomography scanning. Preoperative imaging data were used to reconstruct 3D images of anatomical structures, including the tumor, portal vein (PV), SMV, and splenic vein (SV). Using AR software installed on a smart phone, the reconstructed 3D images were superimposed on the surgical field as viewed in a smart phone display to provide intermittent navigational assistance to the surgeon in identifying the boundaries of PHC tumor invasion for resection of the vessels involved. Result. All patients successfully completed the operation. Intraoperative AR applications displayed virtual images of the pancreas, SMV, bile duct, common hepatic artery (CHA), and superior mesenteric artery (SMA). Two patients required end-to-end anastomosis for reconstruction of the SMV. One patient required allogenic vascular bypass to reconstruct the SMV-PV juncture with concomitant reconstruction of the SV-SMV confluence by end-to-side anastomosis of the SV and bypass vessel. Postoperative pathology confirmed R0 resections for all patients. Conclusion. AR navigation technology based on preoperative CT image data can assist surgeons performing PD with SMV resection and reconstruction.

scholarly journals Augmented Reality with HoloLens® in Parotid Tumor Surgery: A Prospective Feasibility Study

ORL ◽  
2021 ◽  
pp. 1-10
Author(s):  
Claudia Scherl ◽  
Johanna Stratemeier ◽  
Nicole Rotter ◽  
Jürgen Hesser ◽  
Stefan O. Schönberg ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Tumor Surgery ◽  
Parotid Tumor ◽  
Hand Gestures ◽  
Surgical Performance ◽  
3D Images ◽  
Additional Information ◽  
Parotid Surgery ◽  
Surgical Field ◽  
Improve Planning

<b><i>Introduction:</i></b> Augmented reality can improve planning and execution of surgical procedures. Head-mounted devices such as the HoloLens® (Microsoft, Redmond, WA, USA) are particularly suitable to achieve these aims because they are controlled by hand gestures and enable contactless handling in a sterile environment. <b><i>Objectives:</i></b> So far, these systems have not yet found their way into the operating room for surgery of the parotid gland. This study explored the feasibility and accuracy of augmented reality-assisted parotid surgery. <b><i>Methods:</i></b> 2D MRI holographic images were created, and 3D holograms were reconstructed from MRI DICOM files and made visible via the HoloLens. 2D MRI slices were scrolled through, 3D images were rotated, and 3D structures were shown and hidden only using hand gestures. The 3D model and the patient were aligned manually. <b><i>Results:</i></b> The use of augmented reality with the HoloLens in parotic surgery was feasible. Gestures were recognized correctly. Mean accuracy of superimposition of the holographic model and patient’s anatomy was 1.3 cm. Highly significant differences were seen in position error of registration between central and peripheral structures (<i>p</i> = 0.0059), with a least deviation of 10.9 mm (centrally) and highest deviation for the peripheral parts (19.6-mm deviation). <b><i>Conclusion:</i></b> This pilot study offers a first proof of concept of the clinical feasibility of the HoloLens for parotid tumor surgery. Workflow is not affected, but additional information is provided. The surgical performance could become safer through the navigation-like application of reality-fused 3D holograms, and it improves ergonomics without compromising sterility. Superimposition of the 3D holograms with the surgical field was possible, but further invention is necessary to improve the accuracy.

scholarly journals Splenic vein reconstruction is unnecessary in pancreatoduodenectomy combined with resection of the superior mesenteric vein–portal vein confluence according to short-term outcomes

HPB ◽  
2017 ◽  
Vol 19 (9) ◽  
pp. 785-792 ◽  
Author(s):  
Haruyoshi Tanaka ◽  
Akimasa Nakao ◽  
Kenji Oshima ◽  
Kiyotsugu Iede ◽  
Yukiko Oshima ◽  
...  
Keyword(s):  
Portal Vein ◽  
Superior Mesenteric Vein ◽  
Splenic Vein ◽  
Short Term ◽  
Mesenteric Vein

Contribution of Superior Mesenteric Vein Flow to the Right and Left Lobes of the Liver Using CFD

2009 ◽  
Author(s):  
Stephanie M. George ◽  
Diego R. Martin ◽  
Don P. Giddens
Keyword(s):  
Portal Vein ◽  
Superior Mesenteric Vein ◽  
Splenic Vein ◽  
Normal Subjects ◽  
Diagnostic Techniques ◽  
Mesenteric Vein ◽  
Right Lobe ◽  
Computational Fluid Dynamics Cfd ◽  
The Right ◽  
End Stage

The incidence of cirrhosis, the end stage for many liver diseases, is rising and with it the need for better understanding of the progression of the disease and diagnostic techniques. The authors have noted that liver disease occurs preferentially in the right side of the liver which is the largest lobe. One hypothesis is that this is due to the composition of the blood that supplies the right lobe. The liver is fed by both the hepatic artery and the portal vein with the portal vein contributing about 80% of the blood supply. The portal vein (PV) is supplied by the superior mesenteric vein (SMV), which drains blood from the digestive track, and the splenic vein (SV), which drains blood from the spleen. Since the blood in the SMV is coming from the digestive track, it carries toxins and items absorbed during digestion. Toxins such as alcohol are known to damage the liver. Thus, our hypothesis is that the majority of the SMV flow feeds into the right portal vein and ultimately the right lobe of the liver. This study seeks to assess the validity of our hypothesis in four subjects by creating subject specific models in two normal subjects and two patients and using computational fluid dynamics (CFD) to calculate the SMV contribution to the right portal vein.

Splenic Vein Turndown Repair in Superior Mesenteric Vein Trauma: A Reasonable Alternative

2010 ◽  
Vol 45 (2) ◽  
pp. 191-194 ◽  
Author(s):  
Brett T. Phillips ◽  
Garri Pasklinsky ◽  
Kevin T. Watkins ◽  
James A. Vosswinkel ◽  
Apostolos K. Tassiopoulos
Keyword(s):  
Superior Mesenteric Vein ◽  
Splenic Vein ◽  
Mesenteric Vein ◽  
Reasonable Alternative

scholarly journals Diagnosis of portal hypertension by transabdominal ultrasound

2015 ◽  
Vol 47 (1-2) ◽  
pp. 21-24
Author(s):  
Md Saad Ahamed ◽  
Shikha Kabir ◽  
AS Mohiuddin ◽  
Poritosh Kumar Chowdhury
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Superior Mesenteric Vein ◽  
Statistical Significance ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Deep Inspiration ◽  
Mesenteric Veins ◽  
Mesenteric Vein ◽  
Imaging Department

Portal hypertension is pathologic increase in portal venous pressure, with diversion of portal blood to the systemic circulation. The study was directed to measure as well as to compare the diameters of splenic, superior mesenteric and portal veins with their variation with respiration in normal subjects and in patients with portal hypertension. An analytic type of cross-sectional study was conducted at Radiology and Imaging Department of BIRDEM, Shahbag, Dhaka for one year (2011-12) among purposively selected 59 study subjects with chronic liver disease and portal hypertension, and 45 individuals without liver disease. Transabdominal ultrasonograpy of hepatobiliary system was carried out using computed sonography system with multiple probes having multiple frequency depending on physical built of the subjects. The diameters of selected veins were measured in the course of expiration and deep inspiration. In all control subjects, diameter variations of splenic vein and superior mesenteric vein were noted in the phases of respiration, the diameters increased during deep inspiration and decreased during deep expiration mean diameter and standard deviation of splenic vein and superior mesenteric vein were 6.95 ± 1.75 mm and 8.77 ± 2.06 mm respectively and during expiration they were 4.45 ± 1.24 mm and 5.66 ± 1.41 mm respectively. The difference in deep inspiratory and expiratory diameters had high statistical significance (p<0.0001). Patients with portal hypertension diameter variation with breathing at the level of splenic and superior mesenteric veins was observed only in 5 (9.47%) cases. Diminished response of splenic and superior mesenteric veins with respiration in transabdominal ultrasonography is an indicator of portal hypertension. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22558 Bang Med J (Khulna) 2014; 47 : 21-24

scholarly journals Metastatic Melanoma to the Pancreas with a Thrombus in the Splenic Vein and Superior Mesenteric Vein: A Case Report

2009 ◽  
Vol 61 (5) ◽  
pp. 325
Author(s):  
Seong Sook Hong ◽  
Jung Hoon Kim ◽  
Kui Hyang Kwon ◽  
Duek Lin Choi ◽  
Sung Tae Park ◽  
...  
Keyword(s):  
Case Report ◽  
Metastatic Melanoma ◽  
Superior Mesenteric Vein ◽  
Splenic Vein ◽  
Mesenteric Vein
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