Merging realities: Virtual and augmented platforms utilization for complex chest wall surgery-a case series.

Authors

Timothy Veit, John Howington, Mia DeBarros, Thomas Templin, Daniel Cuadrado, John Kuckelman

Published in

The journal of trauma and acute care surgery. Jul 14, 2026. Epub Jul 14, 2026.

Abstract

Accurate preoperative planning and incision design remain critical challenges in complex chest wall surgery. Virtual reality (VR) and augmented reality (AR) enable immersive, patient-specific visualization that may improve anatomic understanding and operative precision. We evaluated their use for preoperative planning and intraoperative guidance in chest wall repair and reconstruction.
Five thoracic surgeons utilized VR and/or AR planning in 35 consecutive patients undergoing chest wall procedures over a nine-month period at two trauma centers. High-resolution computed tomography (CT) imaging was uploaded into a VR platform for preoperative planning, and AR was optionally used intraoperatively to project three-dimensional anatomy, assisting with incision planning and trajectory verification without altering standard operative workflow. Data were extracted from the electronic medical record and analyzed using descriptive statistics.
Mean age was 59 years (range: 26 to 89), mean BMI was 28 kg/m², and 57% of patients were male. Combined VR/AR was used in 77% of cases, whereas 22% underwent VR-only planning due to early connectivity and AR calibration limitations. One patient did not proceed to surgery after VR/AR review. The mean interval from CT acquisition to surgery was 5 days overall and 1.5 days for nonelective cases. Procedures included 10 chest wall reconstructions, 22 rib fracture fixations (mean 4 ribs plated), one sternal fixation, and two chest wall mass excisions. The most common incision was a muscle-sparing "line-of-best-fit" approach (n=25). Mean operative time was 93 minutes. No intraoperative complications related to VR or AR were observed.
Integration of VR and AR platforms for complex chest wall surgery was feasible within our practice. These technologies supported incision planning, hardware orientation, and spatial mapping without apparent disruption to operative workflow, suggesting a potentially useful adjunct for chest wall repair and reconstruction.
Level V, case series.

PMID:
42447442
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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