title: Three-dimensional imaging navigation during a lung segmentectomy using an iPad.
abstract: OBJECTIVE
  The requirement for anatomical lung segmentectomies has increased in recent years but this surgical procedure is relatively difficult. We herein present the benefits of using three-dimensional (3D) imaging navigation during a lung segmentectomy via the intra-operative use of an iPad.
  
  
  METHODS
  Fourteen patients who had undergone an anatomic segmentectomy for a primary lung cancer or a metastatic lung tumour between 1 October 2010 and 30 April 2011 were included in this study. Contrast-enhanced scanning was performed twice on each patient, and 3D images were constructed using a workstation. These images were then transferred to an iPad and analysed during the operation using DICOM image viewer software.
  
  
  RESULTS
  The study group included 3 men (21%) and 11 women (79%) ranging in age from 57 to 83 (mean 69 ± 7.8 years). The operative procedure involved a resection in one case each of the right S1, the right S2, the right S2 + S6a, the right S3, the right S6, the left S8 and the left S8 + 9. The left S1 + 2 and the left basal segment were resected in two cases. The left upper division was resected in three cases. All segmentectomies were successful and no major post-operative complications developed in any patient during or after their procedures. No positive margins were detected pathologically.
  
  
  CONCLUSIONS
  A 3D computed tomography navigation using an iPad enhances the ability to perform a safe and secure segmentectomy.
authors.affiliation: Department of Thoracic Surgery, Ina Central Hospital, Ina, Japan. tks1976@shinshu-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Eguchi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Takasuna
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kitazawa
authors.forename: Youhei
authors.initials: Y
authors.lastname: Fukuzawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakaue
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Makoto
authors.initials: M
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000295:instrumentation* / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods