Perspectives in the Current and Future Use of Augmented Reality Visualization in Thoracic Surgery and Pulmonary Interventions

  • Mohamed A. ElarrefEmail author
  • Ahmed Aljabary
  • Nabil A. Shallik
  • Mohamed Abbas
  • Noran Elarif


The purpose of this chapter is to review the role of virtual bronchoscopy and 3-D imaging of the airways in clinical practice.

Virtual bronchoscopy generates high-definition tracheobronchial tree pictures and endobronchial views which mimic traditional bronchoscopy.

Patient preparation for surgical intervention takes time and effort and for the anaesthetist the most important is airway assessment.

Virtual bronchoscopy (VB) is an animated 3-D CT post-processing practice that generates high-definition tracheobronchial tree photos and endobronchial views that mimic standard bronchoscopy reports. The most important limitations of fibre-optic bronchoscopy being inability to advance beyond the 4–5 (dichotomous) division and its invasiveness on high-risk patients raised a strain to figure out a non-invasive technique.

Inhalational injury produces mucosal changes that can’t be easily detected by ordinary CT in the acute phase of injury when there is no airway narrowing or obstruction. Evaluation of how reliable is multi-detector computed tomography (VB) to detect such injury is a new emerging modality in this field.

Also VB is utilized as a quick guide for transbronchial needle aspiration biopsy. It provides higher assurance in the examination of little nodes and nodes in very difficult places; in addition it reduces technique moment.

Virtual bronchoscopic navigation had been used before closing the endobronchial fistula in postoperative bronchopleural fistula. VB is an important diagnostic screening tool in postoperative lung transplantation patients to diagnose any airflow obstruction by using the correlation between VB and pulmonary functions tests.

Data sets from MDCT that are used for VB can also be used to obtain volumetric data that can be utilized to produce in vivo airway casts and anatomic 3D models that can be used for 3D printing.


Three-dimensional imaging Multi-detector computer tomography Augmented reality visualization Airway evaluation Virtual bronchoscopy Augmented reality-guided techniques Lung segmentation 

Supplementary material

Movie 9.1

Virtual bronchoscopy and VRT movies as a non-invasive method that allows accurate grading of tracheobronchial stenosis (AVI 28903 kb)

Movie 9.2

MDCT scan reveals absent left lung, obliterated left main bronchus with nippling, absent left pulmonary artery and significant hyperinflation of the right lung crossing to the left through the anterior mediastinum (AVI 6050 kb)

Movie 9.3

MDCT scan reveals absent left lung, obliterated left main bronchus with nippling, absent left pulmonary artery and significant hyperinflation of the right lung crossing to the left through the anterior mediastinum (AVI 21999 kb)

Movie 9.4

MDCT scan reveals absent left lung, obliterated left main bronchus with nippling, absent left pulmonary artery and significant hyperinflation of the right lung crossing to the left through the anterior mediastinum (AVI 2319 kb)

Movie 9.5

MDCT scan reveals absent left lung, obliterated left main bronchus with nippling, absent left pulmonary artery and significant hyperinflation of the right lung crossing to the left through the anterior mediastinum (AVI 9459 kb)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mohamed A. Elarref
    • 1
    • 2
    • 3
    Email author
  • Ahmed Aljabary
    • 2
  • Nabil A. Shallik
    • 1
    • 2
    • 3
  • Mohamed Abbas
    • 4
  • Noran Elarif
    • 5
  1. 1.Department of Clinical AnesthesiologyWeill Cornell Medical College in Qatar (WCMQ)DohaQatar
  2. 2.Department of Anesthesiology, ICU and Perioperative MedicineHamad Medical CorporationDohaQatar
  3. 3.Department of Anesthesiology and Surgical Intensive Care, Faculty of MedicineTanta UniversityTantaEgypt
  4. 4.Radiology DepartmentDetroit Medical CenterDetroitUSA
  5. 5.Cardiology DepartmentNational Heart InstituteCairoEgypt

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