術前シミュレーション

Preoperative Virtual Reality Surgical Simulation

Point

・融合三次元画像を用いたバーチャルリアリティ術前シミュレーションは詳細な手術検討に有用である．

・Feeding centerを処理することによって出血コントロールが容易になり，術野の視認性が向上し，神経機能温存や確実な腫瘍摘出が見込まれる．

・Feeding centerを早期に処理できる最短のアプローチルートを術前シミュレーションで検討する．

　In this study, the application of virtual reality (VR) neurosurgical simulation using 3-dimensional image fusion for preoperative planning of cerebellopontine angle meningiomas is described. Fusion 3-dimensional images are reconstructed from medical imaging modalities, such as computed tomography and magnetic resonance imaging, allowing precise visualization of tumors and adjacent anatomical structures. Surgical planning involves identifying a tumor's location, extent, dural attachment, and the feeding center, in particular, which is a vascular entry point that correlates with the tumor's dural attachment. Early feeding center identification and coagulation can significantly reduce intraoperative bleeding, facilitate tumor resection, and preserve surrounding healthy tissues. A medical device certificated application, namely‘GRID,'was used for preoperative simulation. Two clinical cases showed how VR simulation clarified the tumor's spatial relationship with the cranial nerves and major vessels, enabling safe and effective surgical strategies. The simulation process helped identify critical neurovascular structures, such as the trigeminal nerve, and optimized the craniotomy and approach routes. VR surgical simulation is a valuable tool for improving both operative safety and efficiency and as an educational method for neurosurgical planning and anatomical understanding.