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Giacalone G, Yamamoto T, Belva F, et al. The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation. J Clin Med. 2019;8(3)doi: 10.3390/jcm8030371.
Giacalone, G., Yamamoto, T., Belva, F., Hayashi, A., Dori, Y., Zviman, M. M., Gysen, M., Nam, H. H., Jolley, M. A., & Kato, M. (2019). The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation. Journal of clinical medicine, 8(3), . https://doi.org/10.3390/jcm8030371
Giacalone, Guido, et al. "The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation." Journal of clinical medicine vol. 8,3 (2019). doi: https://doi.org/10.3390/jcm8030371
Giacalone G, Yamamoto T, Belva F, Hayashi A, Dori Y, Zviman MM, Gysen M, Nam HH, Jolley MA, Kato M. The Application of Virtual Reality for Preoperative Planning of Lymphovenous Anastomosis in a Patient with a Complex Lymphatic Malformation. J Clin Med. 2019 Mar 15;8(3). doi: 10.3390/jcm8030371. PMID: 30884770; PMCID: PMC6463145.
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J Clin Med. 2019 Mar 15;8(3). doi: 10.3390/jcm8030371.

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

Journal of clinical medicine

Guido Giacalone, Takumi Yamamoto, Florence Belva, Akitatsu Hayashi, Yoav Dori, Menekhem M Zviman, Mieke Gysen, Hannah H Nam, Matthew A Jolley, Motoi Kato

Affiliations

  1. Department of Lymphatic Surgery, Sint-Maarten Hospital, 2800 Mechelen, Belgium. [email protected].
  2. Department of Plastic and Reconstructive Surgery, National Center for Global Health and Medicine (NCGM), 162-8655 Tokyo, Japan. [email protected].
  3. Department of Lymphatic Surgery, Sint-Maarten Hospital, 2800 Mechelen, Belgium. [email protected].
  4. Department of Breast Center, Kameda Medical Center, 296-8602 Chiba, Japan. [email protected].
  5. Center for Lymphatic Imaging and Interventions, Children's Hospital of Philadelphia/Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. [email protected].
  6. Department of Radiology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USA. [email protected].
  7. Department of Nuclear Medicine, Heilig Hartziekenhuis, 2400 Mol, Belgium. [email protected].
  8. Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. [email protected].
  9. Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. [email protected].
  10. Division of Pediatric Cardiology, Children's Hospital of Philadelphia, PA 19104, USA. [email protected].
  11. Saitama Children's Medical Center, Department of Plastic and Reconstructive Surgery/Lymph Clinic, Saitama 330-8777, Japan. [email protected].

PMID: 30884770 PMCID: PMC6463145 DOI: 10.3390/jcm8030371

Abstract

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.

Keywords: lymphatic malformation; lymphedema; lymphovenous anastomosis; virtual reality

Conflict of interest statement

The authors declare no conflict of interest.

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