The virtual reality tool VirSSPA in planning DIEP microsurgical breast reconstruction

Gómez-Cía, Tomás; Gacto-Sánchez, Purificación; Sicilia, D.; Suárez, Cristina Justo; Acha, Begoña; Serrano, Carmen; Parra, Carlos; Higuera, Javier de la

doi:10.1007/s11548-009-0311-4

Cited by 23 publications

(12 citation statements)

References 20 publications

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“…It could help the teaching of junior trainees in the art of assessing patients and to do virtual reality navigation and dissection before surgery [20]. However, until we improve tactile platforms for virtual dissection, this is not reasonable.…”

Section: Discussionmentioning

confidence: 99%

Best choice of perforator vessel in autologous breast reconstruction: Virtual reality navigation vs radiologist analysis. A prospective study

Suffee¹,

Pigneur²,

Rahmouni³

et al. 2015

Journal of Plastic Surgery and Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Best choice of perforator vessel in autologous breast reconstruction: Virtual reality navigation vs radiologist analysis. A prospective study

Suffee¹,

Pigneur²,

Rahmouni³

et al. 2015

Journal of Plastic Surgery and Hand Surgery

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“…Forty patients proposed for uni (35) or bilateral [5] breast reconstruction, either immediate or delayed, were included after signing the informed consent to participate in the current study.…”

Section: Methodsmentioning

confidence: 99%

“…Software tools to enhance identification and characterization of perforators have been proposed in the past. VirSSPA, for example, is a virtual reality tool allowing the imaging team to show results of their self-analysis to the surgical team in a 3D environment [5]. In another study, a plugin was developed to make the delineation of perforators and their characterization easier [6].…”

Section: Introductionmentioning

confidence: 99%

Automatic detection of perforators for microsurgical reconstruction

et al. 2020

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a b s t r a c tThe deep inferior epigastric perforator (DIEP) is the most commonly used free flap in mastectomy reconstruction.Preoperative imaging techniques are routinely used to detect location, diameter and course of perforators, with direct intervention from the imaging team, who subsequently draw a chart that will help surgeons choosing the best vascular support for the reconstruction.In this work, the feasibility of using a computer software to support the preoperative planning of 40 patients proposed for breast reconstruction with a DIEP flap is evaluated for the first time. Blood vessel centreline extraction and local characterization algorithms are applied to identify perforators and compared with the manual mapping, aiming to reduce the time spent by the imaging team, as well as the inherent subjectivity to the task.Comparing with the measures taken during surgery, the software calibre estimates were worse for vessels smaller than 1.5 mm (P ¼ 6e-4) but better for the remaining ones (P ¼ 2e-3). Regarding vessel location, the vertical component of the software output was significantly different from the manual measure (P ¼ 0.02), nonetheless that was irrelevant during surgery as errors in the order of 2e3 mm do not have impact in the dissection step.Our trials support that a reduction of the time spent is achievable using the automatic tool (about 2 h/ case).The introduction of artificial intelligence in clinical practice intends to simplify the work of health professionals and to provide better outcomes to patients. This pilot study paves the way for a success story.

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“…Additional information that can be obtained by CTA includes venous communication between the right and left abdomen, cutaneous perforators, as well as other parameters that can be used to calculate flap viability and flap weights, all of which can help preoperative planning by surgical teams [3,25,26]. Recent research has shown that 3-D postprocessing of CTA data may also improve accuracy in identifying perforators [6,[27][28][29]. CTA has been accepted as the gold standard in preoperative planning for DIEP flaps with sensitivity of 96% for all perforators and sensitivity of 100% for perforators > 1 mm [30].…”

Section: Preoperative Imagingmentioning

confidence: 99%

ACR Appropriateness Criteria® Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery)

Imaging

Oliva

Day

et al. 2017

Journal of the American College of Radiology

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Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity. Accurate identification and measurement of the perforator branches of the deep inferior epigastric artery is pivotal during pre-operative planning so that the surgeon can prioritize the best vessel to use and ultimately improve clinical outcome. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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The virtual reality tool VirSSPA in planning DIEP microsurgical breast reconstruction

Abstract: VirSSPA provides additional and potentially more accurate data over conventional CTA with regard to the site of the best perforators and its course through the muscle for DIEP micro-vascular surgery.

Cited by 23 publications

References 20 publications

Best choice of perforator vessel in autologous breast reconstruction: Virtual reality navigation vs radiologist analysis. A prospective study

Best choice of perforator vessel in autologous breast reconstruction: Virtual reality navigation vs radiologist analysis. A prospective study

Automatic detection of perforators for microsurgical reconstruction

ACR Appropriateness Criteria® Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery)

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