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The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation

The management of lymphatic malformations (LMs) is challenging, particularly for large and complex lesions involving anatomical structures in the adjacent tissue. While lymphovenous anastomosis (LVA) has been reported as an effective treatment for lymphedema, it has hardly been described as a treatm...

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Autores principales: Giacalone, Guido, Yamamoto, Takumi, Belva, Florence, Hayashi, Akitatsu, Dori, Yoav, Zviman, Menekhem M., Gysen, Mieke, Nam, Hannah H., Jolley, Matthew A., Kato, Motoi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463145/
https://www.ncbi.nlm.nih.gov/pubmed/30884770
http://dx.doi.org/10.3390/jcm8030371
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author Giacalone, Guido
Yamamoto, Takumi
Belva, Florence
Hayashi, Akitatsu
Dori, Yoav
Zviman, Menekhem M.
Gysen, Mieke
Nam, Hannah H.
Jolley, Matthew A.
Kato, Motoi
author_facet Giacalone, Guido
Yamamoto, Takumi
Belva, Florence
Hayashi, Akitatsu
Dori, Yoav
Zviman, Menekhem M.
Gysen, Mieke
Nam, Hannah H.
Jolley, Matthew A.
Kato, Motoi
author_sort Giacalone, Guido
collection PubMed
description The management of lymphatic malformations (LMs) is challenging, particularly for large and complex lesions involving anatomical structures in the adjacent tissue. While lymphovenous anastomosis (LVA) has been reported as an effective treatment for lymphedema, it has hardly been described as a treatment for LM. Virtual reality has the ability to visualize human structures in three dimensions and can be used for the preoperative planning of complex cases. Here, we describe the first case of the management of an LM by LVA preoperatively planned with virtual reality. A young woman presented with an LM previously treated by gross excision. Following persistent complaints of swelling, a minimally invasive microsurgical intervention was planned. The results of the single photon emission tomography with computed tomography (SPECT-CT) and lymphoscintigraphy were analyzed using a virtual reality program, and a 3D patient-specific model was constructed. Based on the combined findings of this 3D model and lymphography with a fluorescent marker, a precise skin incision could be determined and one lymph vessel was anastomosed to a nearby vein. The swelling of the thigh reduced and the discomfort disappeared. Although more reports are needed to confirm its efficacy, LVA planned with virtual reality constructed images appears to be a valuable treatment option for complex lesions, including LMs.
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spelling pubmed-64631452019-04-19 The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation Giacalone, Guido Yamamoto, Takumi Belva, Florence Hayashi, Akitatsu Dori, Yoav Zviman, Menekhem M. Gysen, Mieke Nam, Hannah H. Jolley, Matthew A. Kato, Motoi J Clin Med Case Report The management of lymphatic malformations (LMs) is challenging, particularly for large and complex lesions involving anatomical structures in the adjacent tissue. While lymphovenous anastomosis (LVA) has been reported as an effective treatment for lymphedema, it has hardly been described as a treatment for LM. Virtual reality has the ability to visualize human structures in three dimensions and can be used for the preoperative planning of complex cases. Here, we describe the first case of the management of an LM by LVA preoperatively planned with virtual reality. A young woman presented with an LM previously treated by gross excision. Following persistent complaints of swelling, a minimally invasive microsurgical intervention was planned. The results of the single photon emission tomography with computed tomography (SPECT-CT) and lymphoscintigraphy were analyzed using a virtual reality program, and a 3D patient-specific model was constructed. Based on the combined findings of this 3D model and lymphography with a fluorescent marker, a precise skin incision could be determined and one lymph vessel was anastomosed to a nearby vein. The swelling of the thigh reduced and the discomfort disappeared. Although more reports are needed to confirm its efficacy, LVA planned with virtual reality constructed images appears to be a valuable treatment option for complex lesions, including LMs. MDPI 2019-03-15 /pmc/articles/PMC6463145/ /pubmed/30884770 http://dx.doi.org/10.3390/jcm8030371 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Giacalone, Guido
Yamamoto, Takumi
Belva, Florence
Hayashi, Akitatsu
Dori, Yoav
Zviman, Menekhem M.
Gysen, Mieke
Nam, Hannah H.
Jolley, Matthew A.
Kato, Motoi
The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title_full The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title_fullStr The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title_full_unstemmed The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title_short The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation
title_sort application of virtual reality for preoperative planning of lymphovenous anastomosis in a patient with a complex lymphatic malformation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463145/
https://www.ncbi.nlm.nih.gov/pubmed/30884770
http://dx.doi.org/10.3390/jcm8030371
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