Three-Dimensional Reconstruction and Extended Reality in Thoracic Surgery - Japanese Expert Recommendations From the Anatomy on the Border Expert Consensus Meeting

Sep 29, 2026

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Precise spatial understanding of the bronchovascular tree is essential for anatomical lung resection. This study evaluates current use and efficacy of three-dimensional reconstruction and extended-reality technologies in Japanese thoracic surgery and formulates expert recommendations. Clinical survey questions were sent to 125 certified centers and PubMed searches reviewed thoracic 3D and XR evidence, refined during the Anatomy on the Border expert consensus meeting. Results address adoption rates, perceived usefulness, and reported outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Methods

Results

Conclusions

Asian Journal of Endoscopic Surgery ORIGINAL ARTICLE OPEN ACCESS Three-Dimensional Reconstruction and Extended Reality in Thoracic Surgery: Japanese Expert Recommendations From the Anatomy on the Border Expert Consensus Meeting Yujin Kudo1 | Daisuke Asano2 | Satoshi Kobayashi3 | Kentato Miura4 | Toshiya Abe5 | Kenoki Ohuchida5 | Mingyon Mun6 | Kimihiro Shimizu4 | Hisashi Iwata7 | Keiichi Akahoshi2 | Go Wakabayashi8 | Tomoharu Yoshizumi9 | Atsushi Takenaka10 | Tomonori Habuchi11 | Masafumi Nakamura5 | Yuko Kitagawa12 | Masatoshi Eto3 | Minoru Tanabe13 | Norihiko Ikeda1 1Department of Surgery, Tokyo Medical University, Tokyo, Japan | 2Department of Hepatobiliary and Pancreatic Surgery, Institute of Science Tokyo, Tokyo, Japan | 3Department of Urology, Kyushu University, Fukuoka, Japan | 4Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Nagano, Japan | 5Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan | 6Department of Thoracic Surgical Oncology, Cancer Institute Hospital of JFCR, Tokyo, Japan | 7Department of General Thoracic Surgery, Gifu University Hospital, Gifu, Japan | 8Department of Surgery, Ageo Central General Hospital, Saitama, Japan | 9Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan | 10Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Tottori, Japan | 11Department of Urology, Akita University Graduate School of Medicine, Akita, Japan | 12Department of Surgery, Keio University School of Medicine, Tokyo, Japan | 13Kashiwa Municipal Hospital, Chiba, Japan Correspondence: Norihiko Ikeda ([ikeda@wd5.so-net.ne.jp](ikeda@wd5.so-net.ne.jp)) | Minoru Tanabe ([minoru.tanabe@kashiwacity-hp.or.jp](minoru.tanabe@kashiwacity-hp.or.jp)) | Masatoshi Eto ([eto.masatoshi.717@m.kyushu-u.ac.jp](eto.masatoshi.717@m.kyushu-u.ac.jp)) Received: 9 November 2025 | Accepted: 13 November 2025 Keywords: 3D reconstruction | augmented reality | mixed reality | navigation | thoracic surgery | virtual reality ABSTRACT Introduction: Precise spatial understanding of the bronchovascular tree is essential for anatomical lung resection. Threedimensional (3D) reconstruction and extended-reality (XR) technologies have emerged as tools for preoperative planning, navigation, and education. We aimed to assess the current use and efficacy of 3D and XR technologies in thoracic surgery in Japan and develop expert recommendations. Methods: Two clinical survey questions on the usefulness of 3D imaging in thoracic surgery and that of VR, AR, and MR were sent to 125 certified thoracic surgical centers. PubMed searches targeted thoracic 3D and XR studies, including English-language randomized, prospective, and retrospective studies, systematic reviews, and meta-analyses. Draft statements were refined at the Anatomy on the Border Expert Consensus Meeting (Japan Society for Endoscopic Surgery 2024) . Results: Fifty of the 125 institutions (40%) responded. 3D imaging was used by 96% of the institutions, and 72% used it in all cases.“Very” or “moderately” useful was reported by 94% of the institutions. Main purposes for using 3D imaging were preoperative simulation (84%) and anatomical understanding (86%); 52% of the institutions used 3D imaging for intraoperative reference. For XR, awareness was moderate, but adoption remained limited (8%) . Among respondents, 74% rated its usefulness as uncertain, while only a small proportion found it clearly useful for preoperative simulation, intraoperative localization, and education. Literature search showed that 3D-planning reduces blood loss, operative time, and complications in segmentectomy, whereas XR studies demonstrated improved nodule localization and workflow efficiency. | Yujin Kudo, Daisuke Asano, and Satoshi Kobayashi contributed equally to this study. | | --- | | This is an open access a

FAQs

What problem does the article focus on in thoracic surgery?

It focuses on the need for precise spatial understanding of the bronchovascular tree for anatomical lung resection, especially when planning and navigating complex procedures.

How was the evidence collected for the recommendations?

Two survey questions were sent to 125 certified thoracic surgical centers, and PubMed searches were used to identify thoracic 3D and XR studies, including randomized and observational designs, systematic reviews, and meta-analyses.

What did the study find about the adoption and usefulness of 3D imaging and XR?

3D imaging adoption was high across institutions, with most rating it as “very” or “moderately” useful. XR adoption was limited, and many respondents rated its usefulness as uncertain, despite literature suggesting benefits such as improved nodule localization and workflow efficiency.

Sep 29, 2026

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