OBJECTIVE: To assess the value of a 360-degree Virtual Reality platform for preoperative and intraoperative planning for mediastinal masses.

CASE VIDEO SUMMARY: A 52-year-old female recreational drug user with a history of hypertension, congestive heart failure, and hepatitis C presented to our Emergency Department with new-onset chest pain of several hours' duration and mild dyspnea on exertion. A CT angiogram revealed a 3.6 x 2.4 cm right anterior mediastinal mass with obliteration of the pericardial fat plane. There was an additional 4.0 x 1.5 cm soft tissue mass in the anterior superior mediastinum. The patient had no symptoms of myasthenia gravis such as proximal muscle weakness, diplopia, or ptosis. After intraoperative planning was confirmed with the patient's 360-degree Virtual Reality model, a right robotic-assisted thoracoscopic extended thymectomy was performed. Final pathology revealed a 5.2 cm stage 1, type AB thymoma with negative margins.

CONCLUSIONS: Reviewing the 360-degree Virtual Reality model of the patient's preoperative scans on the VR platform prior to the procedure confirmed the surgical plan and helped the surgeon mentally prepare for the procedure. Additionally, the high-resolution visualization of the patient's anatomy and pathology at any angle provided by the VR model helped reaffirm the surgical decisions made intraoperatively. Furthermore, the VR platform may be used for patient engagement and education in the outpatient clinic.