Simulation and navigation techniques in VATS and RATS

The advent of new imaging techniques has revolutionized our perceptions of anatomy, enabling us to have a detailed, personalized, and intuitive understanding of the anatomical structure. Accordingly, a more profound knowledge of the anatomy has further inspired physicians to develop novel simulation and navigation techniques. In this special series entitled ‘Simulation and Navigation Techniques in VATS/RATS’, we aimed to explore this captivating topic from a broad perspective; beginning with a review of thoracic anatomy, then taking an overview of simulation and navigation techniques, and finally focusing on specific techniques utilized in actual clinical cases.

The first article of this series will review recent anatomical studies of the thorax, since any genre of simulation and navigation technique is founded upon the accurate visualization and understanding of each patient’s anatomy. Especially, the past few decades have seen advances in 3D-imaging techniques that enable the in-depth study of anatomical structures. Such updates in anatomical data and classification have changed how surgeons perceive the anatomy, plan a surgery, and perform procedures. The next review article of the series gives a comprehensive overview of simulation and navigation techniques, with a special focus on techniques used in segmentectomy. Because segmentectomy requires a much better understanding of the bronchial and vascular anatomy, it is a surgical procedure that has particularly flourished with the introduction of imaging, simulation, and navigation techniques. In the last part of this series, we are more than pleased to showcase detailed presentations of actual simulation and navigation techniques, such as indocyanine green (ICG) imaging, radiofrequency identification of nodules, and navigation based on mixed reality, all illustrated within real clinical scenarios.

We hope that this series will serve as a cornerstone for readers interested in understanding fundamental aspects of simulation and navigation techniques. Novel techniques are developed on a daily basis and we will inevitably see updates for this continuously evolving field. We would like to thank all the authors that have participated in this series, especially for the time and effort they devoted to sharing their knowledge and techniques. We also thank the Video-Assisted Thoracic Surgery editorial team for the opportunity to put this special series together.

Acknowledgments

We thank Felix H. Gottlieb for language editing.

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Video-Assisted Thoracic Surgery for the series “Simulation and Navigation Techniques in VATS/RATS”. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://vats.amegroups.com/article/view/10.21037/vats-24-4/coif). The series “Simulation and Navigation Techniques in VATS/RATS” was commissioned by the editorial office without any funding or sponsorship. S.N. served as the unpaid Guest Editor of the series. H.I. served as the unpaid Guest Editor of the series and serves as the unpaid Associate Editor-in-Chief of Video-Assisted Thoracic Surgery from December 2022 to November 2024. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Seshiru Nakazawa

Hitoshi Igai