*Application of Computer-Assisted Surgery System Based on Artificial Intelligence in Pediatric… DOI: http://dx.doi.org/10.5772/intechopen.111509*

considered, followed by a combination of chemotherapy, surgery, radiotherapy, and immunotherapy. The difficulty of surgery lies in separating the tumor from the arteries, thoracic vertebrae, chest wall, and lung lobes. In children, the mediastinum is small, and the tissues are delicate. Thus, it is easy to inadvertently damage blood vessels and nerves during surgery, resulting in massive hemorrhage or vascular injury or even death. Therefore, accurate preoperative positioning is particularly important [27]. In addition, it has been reported that the blood vessels supplying mediastinal tumors are highly variable and may come from intercostal arteries, coronary arteries, the thyroglossal trunk, internal thoracic arteries, bronchial arteries, etc. Mediastinal tumors usually have an abundant blood supply from multiple arteries, and surgical resection may lead to severe blood loss.

Compared with 2D CT images, 3D reconstructed images can better visualize the adjacent relationships of important mediastinal tissues, whether the tumor invades the blood vessels, and the variations of the blood vessels so that surgeons can clarify the anatomical relationships. Hisense CAS aids in the precise localization of mediastinal tumors and the accurate assessment of important and variant vessels to reduce damage to vital organs and vessels [6, 17].

**Figure 6** shows a three-year-old girl with a mediastinal tumor. Enhanced CT of the thorax suggested that the tumor was located in the left posterior part

**Figure 6.** *Computer-assisted resection of mediastinal tumor.*

of the heart and T4-T9 left the paravertebral region, measuring approximately 61.15 mm × 42.00 mm. The tumor pushed the adjacent lung tissue, and part of the tumor extended to the spinal canal (**Figure 6A–C**). 3D reconstruction suggested that the tumor originated from the posterior mediastinum and was closely adhered to the thoracic aorta and thoracic vertebra. The three supply vessels of the tumor came from the branches of the thoracic aorta, and part of the tumor protruded into the intervertebral foramen (**Figure 6D–F**). Intraoperatively, the anatomical relationship of the tumor was approximately the same as the preoperative three-dimensional reconstruction results. The tumor was very densely adherent to the thoracic vertebrae and rib space, and part of the periosteum and rib space were excised to gradually remove the tumor completely (**Figure 6G** and **H**). The postoperative pathological diagnosis was a GNB.

In summary, artificial intelligence technology has made significant breakthroughs and clinical applications in the field of precision surgery. Computer-assisted medical technology combines the interdisciplinary disciplines of imaging, medical image processing, and computer science, focusing on the development of assisted clinical treatment and surgical planning and simulation systems, and has become a frontier in the development of modern medical technology. Computer-assisted pediatric precise surgery improves tumor resection rates and surgical safety in a comprehensive and objective manner using artificial intelligence. In the future, individualized 3D-based precision surgery may be a new direction for surgical research.
