Augmented Reality, Thoracic Surgery, and Improving the Patient Experience
Mené en Chine sur 270 patients présentant des nodules pulmonaires suspects (âge médian : 59 ans ; 63,7 % de femmes), cet essai randomisé multicentrique évalue la non-infériorité, du point de vue de la réussite d'une résection sous-lobaire, d'une localisation percutanée guidée par réalité augmentée en une seule étape par rapport à une localisation guidée par tomodensitométrie en plusieurs étapes
The multicenter randomized clinical trial by Song et al represents the first to my knowledge to demonstrate successful integration of augmented reality (AR)–based digital navigation technologies into thoracic surgical practice. Indeed, AR-guided approaches are already being used in neurosurgery, orthopedics, and breast surgery. By demonstrating that 1-stop AR-guided percutaneous localization is noninferior to conventional computed tomography (CT)–guided localization for sublobar resection of suspected early-stage lung cancer, the investigators have provided solid evidence for a workflow that may facilitate how we approach small, difficult-to-palpate pulmonary nodules in thoracic surgery. Lung cancer screening programs have undoubtedly led to increasing detection of small, subsolid, and ground-glass pulmonary nodules, many of which are impalpable during minimally invasive surgery, necessitating preoperative localization to guide parenchyma-sparing resection. The conventional CT-guided hook wire or dye injection approaches, while effective, impose a fragmented workflow: patients first undergo localization in the radiology suite, and are then transported (often awake, anxious, and sometimes with a needle in their chest) to the operating room to undergo general anesthesia and resection, often with a time lag in between. This “multiple-stop” pathway introduces risks of pneumothorax, marker displacement during transfer, patient discomfort, logistical delays, scheduling challenges, and possibly increased cumulative radiation exposure.
JAMA Surgery , éditorial, 2026