Archive August 2018 XIX, No. 8

Map Out Surgery With a 3D Organ Reconstruction

A patient created a life-sized model of his diseased colon for his surgeon to see.

Daniel Cook

Daniel Cook, Executive Editor


SELF-EXAM Patient Larry Smarr, PhD, with a 3D model of his diseased colon in the background.

There'll probably never be another patient like Larry Smarr, PhD, an astrophysicist turned computer scientist who created a life-sized 3D-printed model of his inflamed sigmoid colon and then made a virtual reality PowerPoint presentation of his disease process for his surgeon.

"Come over to my Cave and look at my colon," is how Dr. Smarr worded his invitation to colon and rectal surgeon Sonia Ramamoorthy, MD, FACS, FASCRS, to join him in the virtual reality "Cave" at the California Institute for Telecommunications and Information Technology in La Jolla, Calif., an academic research institution where he serves as founding director.

Dr. Ramamoorthy could hardly believe her eyes when she entered the darkened room. Projected onto a black wall was a 6-foot high 3D image of Dr. Smarr's intestine. She'd never been able to visualize an internal organ as a 3D reconstruction. Doing so changed how she thought about how she'd perform the sigmoid colon resection surgery. Before the first incision, she saw precisely where to resect and she saw the small kink that would add a degree of complexity to the procedure. For a surgeon used to operating based on a 2D image of a patient's MRI or CT scan, Dr. Ramamoorthy saw the future of surgery, one in which surgeons could look up at a virtual reality model on a monitor and down at the flesh-and-blood organ on the table.

"It was unbelievable to see the shape of the organ and how it was oriented in his body," says Dr. Ramamoorthy, chief of the division of colon and rectal surgery at University of California, San Diego Health.

"Visualizing it from various angles gave me the information I needed to start thinking about ways to approach the challenging case long before I entered the OR."

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