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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. 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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.  \nMethods: 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) .  \nResults: 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.  \n\n| Yujin Kudo, Daisuke Asano, and Satoshi Kobayashi contributed equally to this study. |\n| --- |\n| This is an open access a","cbCaiqY78W4BsCSm","https://ap.wps.com/l/cbCaiqY78W4BsCSm","pdf",1052405,"English","# Introduction\n# Methods\n# Results\n# Conclusions","[{\"question\":\"What problem does the article focus on in thoracic surgery?\",\"answer\":\"It focuses on the need for precise spatial understanding of the bronchovascular tree for anatomical lung resection, especially when planning and navigating complex procedures.\"},{\"question\":\"How was the evidence collected for the recommendations?\",\"answer\":\"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.\"},{\"question\":\"What did the study find about the adoption and usefulness of 3D imaging and XR?\",\"answer\":\"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.\"}]","Three-Dimensional Reconstruction and Extended Reality in Thoracic Surgery - Japanese Expert Recommendations From the Anatomy on the Border Expert Consensus Meeting | PDF",1790691526]