Virtual liver resection: computer-assisted operation planning using a three-dimensional liver representation

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 20; no. 2; pp. 157 - 164
• Main Authors: Mise, Yoshihiro, Tani, Keigo, Aoki, Taku, Sakamoto, Yoshihiro, Hasegawa, Kiyoshi, Sugawara, Yasuhiko, Kokudo, Norihiro
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.02.2013; Springer Japan; Wiley Subscription Services, Inc
• Subjects: Abdominal Surgery; computer-assisted surgery; Gastroenterology; Hepatectomy - methods; Hepatology; Humans; Imaging, Three-Dimensional - methods; Liver; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Medicine; Medicine & Public Health; Reproducibility of Results; Review Article; Surgery; Surgery, Computer-Assisted - methods; surgical navigation; Surgical Oncology; Tomography, X-Ray Computed - methods; User-Computer Interface; virtual hepatectomy; Virtual hepatectomy; Computer-assisted surgery; Surgical navigation
• ISSN: 1868-6974; 1868-6982; 1868-6982
• DOI: 10.1007/s00534-012-0574-y

In liver surgery, understanding the complicated liver structures and a detailed evaluation of the functional liver remnant volume are essential to perform safe surgical procedures. Recent advances in imaging technology have enabled operation planning using three-dimensional (3D) image–processing software. Virtual liver resection systems provide (1) 3D imaging of liver structures, (2) detailed volumetric analyses based on portal perfusion, and (3) quantitative estimates of the venous drainage area, enabling the investigation of uncharted fields that cannot be examined using a conventional two-dimensional modality. The next step in computer-assisted liver surgery is the application of a virtual hepatectomy to real-time operations. However, the need for a precise alignment between the preoperative imaging data and the intraoperative situation remains to be adequately addressed, since the liver is subject to deformation and respiratory movements during the surgical procedures. We expect that the practical application of a navigation system for transferring the preoperative planning to real-time operations could make liver surgery safer and more standardized in the near future.