Developing Virtual Reality Head Mounted Display (HMD) Set-Up for Thoracoscopic Surgery of Complex Congenital Lung MalFormations in Children.

Maurizio Vertemati,Giulia Lanfranchi,Paolo Milani,Simone Cassin,Sara Costanzo,Alessandro Campari,Sebastiano Panfili,Margherita Roveri,Gianvincenzo Zuccotti,Valeria Calcaterra,Gloria Pelizzo,Anna Camporesi,Francesco Rizzetto

doi:10.3390/children9010050

Abstract

Video assisted thoracoscopic surgery (VATS) has been adopted in pediatric age for the treatment of congenital lung malformations (CLM). The success of VATS in pediatrics largely depends on the surgeon’s skill ability to understand the airways, vascular system and lung parenchyma anatomy in CLM. In the last years, virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients. To date no reports about the use of VR HMD technologies in a pediatric setting are available. The aim of this report is to introduce a VR HMD model in VATS procedure to improve the quality of care in children with CLM. VR HMD set-up for planning thoracoscopic surgery was performed in a series of pediatric patients with diagnosis of CLM. The preoperative VR HMD evaluation allowed a navigation into the malformation with the aim to explore, interact, and make the surgeon more confident and skilled to answer to the traps. A development of surgical simulations models and teaching program dedicated to education and training in pediatric VATS is suitable among the pediatric surgery community. Further studies should demonstrate all the benefits of such technology in pediatric patients submitted to VATS procedure.

Highlights

Congenital lung malformations (CLM) represent a wide range of disorders that include congenital cystic adenomatoid malformation, intra and extra-lobar pulmonary sequestration, bronchogenic cysts, congenital lobar emphysema and bronchial atresia [1,2,3]
CLM have a cumulative incidence of 30–42 cases per 100,000 individuals and they account for 5–18% of all congenital abnormalities; the prevalence may be underestimated because an unknown proportion of CLM is postnatally detected by chance or because of unexplained recurrent or persistent respiratory symptoms or signs [9]
Surgery was performed at 4 months, 4 years and 3 years respectively

Summary

Introduction

Congenital lung malformations (CLM) represent a wide range of disorders that include congenital cystic adenomatoid malformation, intra and extra-lobar pulmonary sequestration, bronchogenic cysts, congenital lobar emphysema and bronchial atresia [1,2,3]. CLM may present with respiratory distress necessitating prompt diagnosis and treatment. Virtual reality (VR) and 3-dimensional (3D) printing of organ models and VR head mounted display (HMD) technologies have been introduced for completion of preoperative planning in adult patients [10,11]. The ability to simultaneously assess cardiovascular and airway components increases the understanding of conditions referred to anatomical anomalies and allows anticipation of potential surgical difficulties in the treatment of adult patients affected by cardiothoracic disease. 3D reconstructions of pulmonary anatomy for a preoperative planning in pulmonary resection is reported in the literature as added value [12,13]

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