Hematinics

All Drugs and Chemicals

Liver Extracts

Group A received first five patient cases and 3D models via DI and another five cases in the VR environment

Group B received first five patient cases and 3D models via VR and another five cases in the DI.

Visualizing 3D models of livers for preoperative surgical planning via two different environment: DI and VR in sequential order

Clinical decision making based on visualizing liver 3D models in Virtual Reality (VR) environment or via a Desktop Interface (DI)

Wouter Willaert, MD, PhD

Roberto Troisi, MD, PhD

Investigators hypothesize that a virtual reality (VR) environment enhances general surgery residents' performance compared to Desktop Interface (DI)-based visualization of 3D models in decision making for patients with liver tumors. To determine this, a proficiency-based stepwise training curriculum for preoperative planning has been developed using both modalities. The overall objective of the curriculum is that by the end of the training program, residents would be able to formulate a treatment plan for patients with liver tumors.

Immersive Virtual Reality Environment for Complex Cognitive Skills Curricular Training in Liver Surgery

Effectiveness of an Immersive Virtual Reality Environment on Curricular Training for Complex Cognitive Skills in Liver Surgery: A Multicentric Crossover Randomized Trial

Residents' decision-making accuracy when reviewing patient data and 3D liver models using DI or VR, measured by comparing their performance to experts' opinions.

The measurement tool will be a questionnaire consisting of ten questions, rate of correct answers will be recorded (e.g. 8/10 correct answers) and higher scores mean a better outcome.

Minimum score=0; Maximum score=10.

Retention of knowledge assessed by validated multiple choice questions. Questionnaire consisted of 15 questions will be used, rate of correct answers will be recorded (e.g. 8/15 correct answers), and higher scores mean a better outcome.

Minimum score=0; Maximum score=15.

Assessed by recognizing intrahepatic structures and 8 liver segments. Questionnaire consisted of 22 questions will be used, rate of correct answers will be recorded (e.g. 8/22 correct answers), and higher scores mean a better outcome.

Minimum score=0; Maximum score=22.

Assessed by total time needed to make decision for 10 patient cases in minutes

University Hospital, Ghent

Department of GI Surgery

Neoplasms

All Conditions

Gland and Hormone Related Diseases

Rare Diseases

Adenoma

Hyperparathyroidism

Hyperparathyroidism, Primary

Parathyroid Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Parathyroid Diseases

Endocrine System Diseases

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Primary Hyperparathyroidism

Parathyroid Hormone

The 3D-VNE model is obtained with VP Planning software (Visible Patient, Strasbourg, France), using DICOM (Digital Imaging and Communications in Medicine) images of contrasted Computed Tomography scan of the neck in operative positioning.

3D-VNE (virtual neck exploration)

Mihaela IGNAT, MD

A prospective database of consecutive patients with hyperparathyroidism subject to surgery is created. Preoperative workup and operative findings are recorded in this registry to allow comprehensive analysis.

This is a non-interventional, prospective, monocentric, non-randomized trial. All patients with biochemically confirmed Primary Hyperparathyroidism (PHPT) who are scheduled for elective parathyroidectomy in the Endocrine and Digestive Surgery Unit of the University Hospital of Strasbourg are considered. Data concerning the age, the operative date, the results of the pre-operative biological work-up (plasma calcium, phosphor, parathyroid hormone (PTH) level, vitamin D), the results of pre-operative imaging (CT (computerized tomography) scan, 99mTc SestaMIBI Scan, 3D-Vitual Neck Exploration (VNE)), the operative data (the surgical approach, the localization and the dimensions of the adenoma (s), the necessity to convert to classical approach and its reason, the values of the intra operative PTH), the pathology results, the biological work-up at follow-up (plasma calcium, phosphor, PTH, vitamin D) are prospectively recorded in the database.

Cohort Trial on Perioperative Localization Techniques of Parathyroid Adenomas

(true positives + true negatives) / number of patients

Sensitivity = True Positives / (True Positives + False Negatives)

Specificity = True Negatives / (True Negatives + False Positives)

Positive predictive value = True Positives / (True Positives + False Positives)

Negative predictive value = True Negatives / (True Negatives + False Negatives)

(True positives + True negatives) / number of patients

Number of patients with minimally invasive parathyroidectomy/ total number of operated patients

Number of patients with classical cervicotomy parathyroidectomy/ total number of operated patients

Number of patients necessitating conversion from minimally invasive parathyroidectomy approach to classical cervicotomy / total number of operated patients

Number of patients with recurrent / total number of operated patients

IHU Strasbourg

Respiratory Tract (Lung and Bronchial) Diseases

Lung Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Using automatic comparison software for 3D reconstruction to determine the size of DLT.

The size of DLT is based on patient's sex and height.

3D reconstruction based on CT data and It reconstructs the trachea and bronchus and compares them with the DLT, predicting the most suitable size of the DLT for lung isolation.

3D reconstruction

In control group, the size of DLT is based on patient's sex and height.

traditional method for selecting double lumen tube

Xin Wang, master

Yihao Zhu, master

The precise and accurate size of DLT is a prerequisite to ensure its accurate position of its placement. Three-dimensional (3D) reconstruction technology can accurately reproduce the tracheobronchial structure to improve the correct size selection of DLT. To make it simpler, the investigators developed an automatic comparison software for 3D reconstruction based on computed tomography data (3DRACS). In this study, the investigators aimed to prove that 3DRACS is much more efficient in endobronchial intubation compared to the traditional method.

Lung isolation techniques are commonly used to facilitate surgical exposure and to provide single-lung ventilation for patients undergoing various intra-thoracic procedures. Lung isolation is primarily accomplished with a double-lumen tube (DLT) or bronchial blocker. One published study showed that residents with limited experience had a 40% error rate in accurately placing a DLT. The accurate choice of the size of DLT is a prerequisite for good lung isolation.Currently, There is lack of proper objective criteria for selecting size of DLT. DLT size selection is estimated empirically using the patient's height and sex, and studies have shown that the size of DLT according CT images of the chest is more accurate than experience. The investigators have developed an automatic comparison software for 3D reconstruction based on CT data (3DRACS). It reconstructs the trachea and bronchus and compares them with the DLT, predicting the most suitable size of the DLT for lung isolation. The aim of this study was to compare whether the use of 3DRACS to select a DLT size compared to conventional empirical selection methods could improve incidence of DLT intubation success and reduce airway injury.

Effect of 3D-printed Reconstruction System in Size of Left DLT

Effect of 3D-printed Reconstruction Automated Matching System in Selecting the Size of Left Double-lumen Tube

Data are available on reasonable request. The raw data are available from the corresponding author with applicable reason after publishing findings to a peer-reviewed journal.

Conventional blindly endobronchial intubation is performed firstly and clinical verification was made by the same anesthesiologist, followed by the supervising anesthesiologist using a FOB to check DLT position and successful intubation was considered if the position was proper.

There are two different situations that we need to describe. First, it starts from the cuff of left DLT crosses the vocal cords, and stops when the left DLT position succeeds without FOB(attempts≤3）. A stopwatch is used for this purpose, where it is ON when the cuff of left DLT crosses the vocal cords and stops when intubating anesthesiologist considers the left DLT is correctly positioned. Second, it starts from the cuff of left DLT crosses the vocal cords and stops when positioning successfully with FOB after three attempts all fail. Each attempt is defined as returning the bronchial lumen of the left DLT to the trachea and then attempting to reinsert it.

If the position of the left DLT under the FOB guidance doesn't match and the intubation fails because of the improper size of the left DLT, we need to change another left DLT.

Objective criteria is injecting air into the cuff. When the pressure inside the left DLT is 25 mmHg, it will be stopped and connected to the anesthesia machine. And the air leakage phenomenon is adjusted when the peak pressure is lower than 30 cm H2O. Oversized left DLT is defined that good pulmonary isolation could be achieved by injecting \<1 ml of air into the bronchial cuff and \<2 ml of air into the main tracheal cuff, while more than 3 or 6 ml of air into the two cuff is defined undersized left DLT.

Ten and 20 min after pleurotomy, the degree of pulmonary atrophy is assessed by a chest surgeon unaware of the grouping with an eleven-point Likert scale with 0 marked as no pulmonary atrophy at all and 10 as most perfect lung collapse.

it will be done by a trained anesthesiologist with over 10 years of FOB experience, The severity of the tracheal injury is defined as mild (redness, edema, one to three speckled hemorrhagic lesions), moderate (over 3 mild lesions or one diffuse hemorrhagic lesion), and severe (more than 2 diffuse hemorrhagic lesions) The type of lesions in vocal cords is classified into edema with inflamed mucosa, petechiae (small red spots on the mucosa), and hematoma (bleeding into the mucosa).

they are defined as persistent resting pain in the throat region, where throat pain scores are assessed using VAS score i.e., 0 for no pain, and 10 for unbearable pain, while hoarseness is defined as a change in the quality of voice observed by the patient.

it is defined as the area under the curve of the SpO2/FiO2 ratio during OLV. The SpO2 and FiO2 values are automatically collected by the monitor at 30-second intervals and any abnormal data due to equipment or human error is replaced with the previous correct data.

The times of using FOB guiding to place the left DLT correctly after three attempts all fail.

Sichuan Cancer Hospital and Research Institute

Clinical Professor

Chest contrast-enhanced computed tomography will be performed preoperatively, and 3-dimensional reconstruction will be formed based on the data of chest CT. Video-assisted segmentectomy will be performed guided by the image of 3-dimensional CT. IPS-lung software (Shenzhen Yorktal Digital Medical Imaging Technology Company, Shenzhen, China) will be used preoperatively to construct a 3D-image to ascertain the position and structure of targeted segmental blood vessels and bronchi.

Chest contrast-enhanced computed tomography will be performed preoperatively. Video-assisted segmentectomy will be performed based on the image of preoperative chest CT

3-dimensional computed tomography reconstruction guided VATS segmentectomy

He-Cheng Li, doctor

Anatomical variations of pulmonary vessel may cause serious problems during pulmonary segmentectomy. Three-dimensional （3D）computed tomography (CT) presents 3D images of pulmonary vessels and the tracheobronchial tree and may help operative planning. Retrospective studies have identified the importance of 3-dimensional CT in the field of pulmonary segmentectomy. And the aim of this study is to compare the usefulness of 3-dimensional CT with standard chest CT in preoperative planning of video-assisted segmentectomy.

Lung cancer has been the most serious malignancy around the world which has the highest morbidity and mortality amount all the malignant tumors. Due to the wide spread of lung cancer screening, more and more early stage lung cancer patients have been diagnosed. Video-assisted segmentectomy is a standard surgical procedure in treating early stage peripheral non-small cell lung cancer (NSCLC). However, anatomical variations of pulmonary vessel may cause serious problems, for example unexpected bleed during surgery. Three-dimensional computed tomography (CT), which is reconstructed based on the standard chest CT image, presents 3D images of pulmonary vessels and the tracheobronchial tree and therefore helps operative planning. There are several retrospective studies addressed the importance of 3-dimensional CT in the field of pulmonary segmentectomy. And the aim of this multicenter randomized controlled trial is to compare the usefulness of 3-dimensional CT and standard chest CT in preoperative planning of video-assisted segmentectomy.

3D Reconstruction in Video-assisted Thoracoscopic Surgery (VATS) Segmentectomy

Three-dimensional Computed Tomography Reconstruction for Operative Planning in VATS Segmentectomy

Rate of anatomical variation of segmental bronchus and pulmonary vessel in Chinese population

the rate of conversion to open surgery in the operation

the accident event happened in operative. For example, a segmentectomy is converted to a lobectomy

mainly include: pneumonia, arrhythmia, incision infection, vocal cord paralysis, trachea cannula

including overall lymph node count, number of stations dissected and number of lymph nodes in each lymph node station

Up to the date of death of any causes since the date of randomization

Up to the date of disease recurrence since the date of randomization

forced expiratory volume at one second（FEV1） in litre, maximal voluntary ventilation （MVV） in litre

Surgical plan is made based of the image of standard chest computed tomography or three-dimensional computed tomography, the targeted segmental bronchus and pulmonary vessels are decided preoperatively. Change of surgical plan is recorded when the actually resected bronchus and vessels are different to those in the preoperative surgical plan

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Immersive Virtual Reality Environment for Complex Cognitive Skills Curricular Training in Liver Surgery	NCT04959630	Hepatobiliary N...	Clinical decisi...	18 Years -	University Hospital, Ghent
Cohort Trial on Perioperative Localization Techniques of Parathyroid Adenomas	NCT04013100	Primary Hyperpa...	3D-VNE (virtual...	18 Years -	IHU Strasbourg
Effect of 3D-printed Reconstruction System in Size of Left DLT	NCT06258954	Cancer of Lung Lung Isolation	3D reconstructi... traditional met...	18 Years - 75 Years	Sichuan Cancer Hospital and Research Institute
3D Reconstruction in Video-assisted Thoracoscopic Surgery (VATS) Segmentectomy	NCT04004494	Segmentectomy	3D reconstructi...	18 Years -	Ruijin Hospital

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