Exploring the Future of Thoracic Surgery: Overlaying 3D Models onto Intraoperative Video

Thoracic surgery demands meticulous planning and execution, particularly for cases of lung cancer resections or patients with prior interventions. Each patient’s anatomy is unique, and surgeons face the constant risk of impacting vital structures such as arteries, veins, and bronchi. Additionally, surgeons aim to resect a safe margin surrounding the tumor to prevent recurrence while sparing as much healthy tissue as possible.

With these challenges in mind, Prof. Dr. Yanina Jansen and Prof. Dr. Lieven Depypere sought a method that offers surgeons a deeper understanding of their patients’ anatomies before and during surgery, enabling them to precisely perform the resection as planned with confidence and efficiency. Dr. Jansen emphasized the significance of this in intricate cases: “The more complex the segments, the more important your 3D image is.”

This goal led them to explore the impact of 3D planning for thoracic surgery and overlaying the resulting 3D models over endoscopic images during surgery. While Orsi Innotech’s AR overlay technology is still in the research phase, this innovative method, combined with advanced 3D planning, has enormous potential value for every lung cancer procedure, from routine to exceptional.

Intraoperative tools like this offer surgeons guidance in real time, precisely achieving the resection as planned and helping them see critical anatomical structures, such as vessels, to prevent bleeding. They also serve as a reference if the anatomy is non-standard — seen in one out of three cases — or unexpected challenges arise. Dr. Depypere explained, “If you have doubts preoperatively, then it’s nice to see the plan during surgery as well. It gives you more clarity.” Although experimental, this method offers real promise.

The team applied this technique to real surgical cases, gaining valuable experience with its value and potential applications. In this case, which was broadcast live during the Orsi Surgical AI Days conference, the team evaluated a lesion near the boundary of two lung segments. Using 3D planning, they pinpointed its exact location and determined whether it was necessary to remove one or two segments. Dr. Jansen shared, “For this case, 3D planning offered more insight. We completed the procedure while preserving as much healthy lung tissue as possible.” This clear view of the patient’s unique anatomy before the operations allowed for more informed and personalized decision-making.

Beyond preoperative clarity, intraoperative assistance provided reassurance throughout the procedure. Dr. Jansen explained, “We were pretty confident that the issue was resolved and we had everything under control, yet we regularly looked back at the 3D image just to ensure we didn’t miss anything.”

The success of this research results from close collaboration between surgeons, radiologists, and engineers from Orsi Innotech and Materialise. It shows great promise in providing surgeons with more confidence, all to ultimately maximize healthy tissue and improve patient outcomes. 

Looking ahead, the team sees opportunities to integrate 3D planning and overlay with other technologies. For example, advancements in robotics and haptic feedback could further enhance surgical precision, while tools like perfusion-ventilation analysis could make it possible to more accurately predict post-operative lung function.

These emerging technologies, paired with the expertise of surgical teams, could represent the next step in advancing safety and precision for thoracic procedures, leading the way for more personalized, effective patient care.