增强现实技术引导腹腔镜在肝癌切除术中的应用价值值(附1例临床报告)  

Application Value of Augmented Reality Guided Laparoscopy in Hepatectomy(A Case Report)

作　　者：谢威[1] 罗嘉[1] 陈攀[1] 康忠诚[1] 吴飞跃[1] 石磊[1] XIE Wei;LUO Jia;CHEN Pan(Department of Hepatobiliary Surgery,Hunan Cancer Hospital,Changsha,Hunan 410013)

机构地区：[1]湖南省肿瘤医院肝胆肠外科,湖南长沙410013

出　　处：《医学临床研究》2019年第12期2367-2369,共3页Journal of Clinical Research

摘　　要：【目的】探讨增强现实技术(AR)联合腹腔镜在切除原发性肝癌中的应用价值。【方法】术前通过核磁共振(MRI)得到的数据进行肝癌患者3D虚拟模型的构建,将构建的3D影像与腹腔镜采集到的图像传送到工作站视频采集卡,通过工作站处理将合成视频投送到手术室视频显示器,最终完成AR构建,应用AR进行切除肝脏肿瘤。【结果】术前构建的肝癌3D影像与腹腔镜术中采集到的肝脏图像,经过工作站的处理,达到精准融合。肝肿瘤位于右肝后叶,约5 cm×5 cm,质地较硬,边界欠清楚,腹腔及盆腔未见明显转移性肿瘤。手术时间约180 min,术中分次阻断肝门共4次,每次15 min,间隔5 min,出血量约300 mL。患者术后d1拔出胃管、进流质饮食,d2下床活动并有排气,d5拔除腹腔引流管,术后d7顺利出院。【结论】AR与腹腔镜的结合,可以术中实时地将腹腔镜得到的图像与术前3D模型准确融合,从而可引导腹腔镜实施精准切除肝脏肿瘤。【Objective】To explore the value of augmented reality combined with laparoscopy in the resection of hepatocelluar carcinoma.【Methods】The 3D virtual model of liver cancer patients was constructed with the data obtained by MRI before operation.The 3D image and the image collected by laparoscope were transferred to the video acquisition card of workstation,and the synthetic video was sent to the video display of operating room through workstation processing.Finally,AR construction was completed and the liver tumor was removed with AR.【Results】The 3D image of liver cancer constructed before operation and the liver image collected during laparoscopic operation are processed by workstation to achieve accurate fusion.The liver tumor was located in the posterior lobe of the right liver,about 5 cm×5 cm.The texture of the tumor was hard,and the boundary was not clear.No metastasis was found in the abdominal cavity and pelvic cavity.The operation time was about 180 minutes,and the hilum of liver was blocked four times during the operation,each time was 15 minutes,the interval was 5 minutes,and the amount of bleeding was about 300 ml.On the day 1,the stomach tube was pulled out and the fluid was fed.On the day 2,the patient got out of bed and had exhaust.On the day 5,the abdominal drainage tube was pulled out.On the day 7,the patient was discharged smoothly.【Conclusion】The combination of AR and laparoscopy can accurately fuse the image obtained by laparoscopy with the 3D model before operation in real time,so as to guide laparoscopy to carry out accurate resection of liver tumor.

关 键 词：肝肿瘤/外科学 肝切除术 腹腔镜检查 

分 类 号：R735.7[医药卫生—肿瘤]