Development of training and simulation programs for tracheobronchial reconstruction surgery using a three-dimensional operable airway model from clinical computed tomography data

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17762
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55040:Respiratory surgery-related
• Research Institution: Japanese Foundation for Cancer Research
• Principal Investigator: HASHIMOTO Kohei 公益財団法人がん研究会, 有明病院 呼吸器外科, 医長 (70464964)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 手術トレーニング / シミュレーション / 気管気管支形成 / 肺がん / ３Dプリンター

Outline of Final Research Achievements

As the first step of 3D modeling for simulation, we succeeded in creating an elaborate soft 3D model from clinical CT data on healthy volunteers, that can be used to perform simulated surgery. First, a 3D design was created from a non-contrast CT of a healthy volunteer. A silicon mold was created by 3D printing the rigid model, and then a soft model was extracted from the mold using urethane. A holder was also developed to reproduce the surgical exposure. It was confirmed that typical bronchoplasty and tracheoplasty can be reproduced with the model. The lesion from the CT of a patient who required bronchial reconstruction surgery was also reproduced on the 3D model. Three models were created, and it was confirmed as a retrospective study that the reconstruction procedure performed on the patient could be reproduced on the models. A patent application based on these results was filed.

Free Research Field

呼吸器外科

Academic Significance and Societal Importance of the Research Achievements

呼吸器外科領域において、肺癌の中枢浸潤やあるいは良性の疾患でも中枢気道の切除再建が必要になることがある。気管・気管支再建術の成否は、手術の根治性や重篤な術後合併症の有無につながるため、呼吸器外科医が習熟するべき重要な技術である。一方で、症例数が減っており臨床経験を積むのが難しくなっている。本トレーニングは、教材としてあらたな学習プラットフォームとなりえる。また、気管支形成術の多くは専門医であっても、分岐部形成などの複雑な症例が存在する。個別化シミュレーションプログラムによって、複雑症例のより良い手術計画を通じた手術成績向上につながる可能性がある。