Digital Virtualization Of Endoscopic Thyroidectomy

Objective：Laparoscopic thyroidectomy is simulated in a personal computer byusing3D processing software. Safe and reasonable surgical plan is madepre-operatively. It is simulated from the parts to the whole and from2D to3D.Methods：From April2010till November2011, one case was selected fromnodular goiter, primary hyperthyroidism, thyroid carcinoma, ectopic thyroid andsecondary thyroid respectively in the1stAffiliated Hospital of Jinan University.Original thyroid CT scan images were imported into Mimics10.01. Establish the3Dmodel of thyroid gland and its surrounding tissues and organs with region growingmethod through threshold segmentation. It was then exported in VRML format one byone after remeshing. Then it was imported into3ds max2012for surgical simulationand individual pre-operative planning for the patients. The matching degree betweenvirtual surgical planning and actual surgical procedure were compared to investigateits clinical value.Results：Laparoscopic thyroidectomy for the five patients were simulated,including gland and tumor resection, treatment of thyroid blood vessels, retainingparathyroid glands, lymph nodes clearance, and so on. The simulation was generallyconsistent with the actual surgical procedure. However, it was failed to establish the3D model of nerves. And the protection of the recurrent laryngeal nerve and superiornerve could not be simulated.Conclusions：By using the3D processing software such as Mimics and3ds max,laparoscopic thyroidectomy could be simulated, which helps surgeons to masterpatients’ condition directly and comprehensively before surgical operation. It alsohelps to develop safe and reasonable pre-operative planning and reduce complications.It shows its significance in guidance and clinical value.