Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Noeska Smit, University of Bergen
- Second opponent: Associate Professor Danilo Miskovic, St Mark’s Hospital and Imperial College London
- Third member and chair of the evaluation committee: Associate Professor Franziska Siafarikas, University of Oslo
Chair of the Defence
Professor emeritus Tom Øresland, University of Oslo
Principal Supervisor
Professor II Dejan Ignjatovic, Faculty of Medicine, University of Oslo
Summary
At Akershus University Hospital, right colectomy with extended D3 mesenterectomy is an advanced surgical technique performed through a clinical trial aiming for the curative treatment of right-sided colon cancer. Before this procedure, it is crucial to obtain a patient-specific navigation map of the central mesenteric vasculature in order avoid complications, such as bleeding.
The main aim of this dissertation was to test and validate different 3D visualization formats of these vascular structures for the surgeon to apply, pre- and intraoperatively, as a navigation tool in colon cancer surgery. The specific aims of the thesis were to find out if 3D printed vascular models are accurate enough to mirror the real linear dimensions of vascular structures; to identify if semi-automated (rapid) methods for creating vascular structures in 3D are accurate enough for clinical use; to test a navigation system for open surgery using holographic imaging (virtual 3D images) and Mixed-Reality technology; and to describe the topography of the superior mesenteric nerve plexus using three different methodological approaches, as well as to assess the degree of nerve plexus injury after performing such advanced surgical resections.
Our first study showed that patient-specific 3D printed vascular models of the central mesentery were accurate enough for clinical implementation.
Our second study proved that rapid methods for creating 3D vascular models of the central mesentery had problems producing anatomically complete models.
Our third study showed that our in-house Mixed-Reality navigation system could provide adequate target precision while simulating open surgery incisions with holographic 3D images as guidance.
Finally, in our fourth study, Nano CT imaging revealed the detailed architecture of the nerve plexus with a slanting rotation of its fibers around the superior mesenteric artery. At the same time, histological comparison showed that at least 59% of the superior mesenteric artery nerve plexus is transected during this type of surgery.
Additional information
Contact the research support staff.