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Computer-assisted 3D-navigated liver resection

Gang Zhang, Xian-Jun Zhou, Cheng-Zhan Zhu, Qian Dong, Lin Su
BACKGROUND: Hepatoblastoma (HB) is the most common malignant liver tumor in childhood. Complete HB surgical resection which is technically demanding is the cornerstone of effective therapy with a good prognosis. The aim of our study is to evaluate the usefulness of 3D simulation software in assisting hepatectomy in pediatric patients with HB. METHODS: 21 children with HB who underwent hepatectomy were enrolled in this study. All patients underwent computer tomography (CT) imaging preoperatively...
September 2016: Surgical Oncology
Rafael Palomar, Faouzi A Cheikh, Bjørn Edwin, Azeddine Beghdadhi, Ole J Elle
Computer-assisted systems for planning and navigation of liver resection procedures rely on the use of patient-specific 3D geometric models obtained from computed tomography. In this work, we propose the application of Poisson surface reconstruction (PSR) to obtain 3D models of the liver surface with applications to planning and navigation of liver surgery. In order to apply PSR, the introduction of an efficient transformation of the segmentation data, based on computation of gradient fields, is proposed. One of the advantages of PSR is that it requires only one control parameter, allowing the process to be fully automatic once the optimal value is estimated...
October 2016: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
T Huber, J Baumgart, M Peterhans, S Weber, S Heinrich, H Lang
BACKGROUND: Modern chemotherapy regimen for colorectal cancer results in complete radiologic remission in a substantial number of cases. However, these "vanished liver metastases" (VLM) often contain vital tumor cells, which mandates the resection of such lesions. In these cases, intraoperative identification of VLM can be challenging, in particular in laparoscopic approaches. We describe the first laparoscopic computer-assisted 3D-navigated resection of a VLM. CASE REPORT: A 60-year-old patient with a synchronous liver metastasis (segment IVb) of sigmoid colon cancer (T4 N1 M1) was referred to our center for elective liver resection after laparoscopic sigmoid resection and systemic chemotherapy (FOLFIRI/Panitumumab)...
January 2016: Zeitschrift Für Gastroenterologie
Julie Hallet, Brice Gayet, Allan Tsung, Go Wakabayashi, Patrick Pessaux
Pre-operative simulation using three-dimensional (3D) reconstructions have been suggested to enhance surgical planning of hepatectomy. Evidence on its benefits for hepatectomy patients remains limited. This systematic review examined the use and impact of pre-operative simulation and intraoperative navigation on hepatectomy outcomes. A systematical searched electronic databases for studies reporting on the use and results of simulation and navigation for hepatectomy was performed. The primary outcome was change in operative plan based on simulation...
May 2015: Journal of Hepato-biliary-pancreatic Sciences
Patrick Pessaux, Michele Diana, Luc Soler, Tullio Piardi, Didier Mutter, Jacques Marescaux
BACKGROUND: Augmented reality (AR) in surgery consists in the fusion of synthetic computer-generated images (3D virtual model) obtained from medical imaging preoperative workup and real-time patient images in order to visualize unapparent anatomical details. The 3D model could be used for a preoperative planning of the procedure. The potential of AR navigation as a tool to improve safety of the surgical dissection is outlined for robotic hepatectomy. MATERIALS AND METHODS: Three patients underwent a fully robotic and AR-assisted hepatic segmentectomy...
April 2015: Langenbeck's Archives of Surgery
Vanessa M Banz, Matthias Baechtold, Stefan Weber, Matthias Peterhans, Daniel Inderbitzin, Daniel Candinas
For patients with extensive bilobar colorectal liver metastases (CRLM), initial surgery may not be feasible and a multimodal approach including microwave ablation (MWA) provides the only chance for prolonged survival. Intraoperative navigation systems may improve the accuracy of ablation and surgical resection of so-called "vanishing lesions", ultimately improving patient outcome. Clinical application of intraoperative navigated liver surgery is illustrated in a patient undergoing combined resection/MWA for multiple, synchronous, bilobar CRLM...
October 28, 2014: World Journal of Gastroenterology: WJG
Ryota Souzaki, Satoshi Ieiri, Munenori Uemura, Kenoki Ohuchida, Morimasa Tomikawa, Yoshiaki Kinoshita, Yuhki Koga, Aiko Suminoe, Kenichi Kohashi, Yoshinao Oda, Toshiro Hara, Makoto Hashizume, Tomoaki Taguchi
PURPOSE: In pediatric endoscopic surgery, a limited view and lack of tactile sensation restrict the surgeon's abilities. Moreover, in pediatric oncology, it is sometimes difficult to detect and resect tumors due to the adhesion and degeneration of tumors treated with multimodality therapies. We developed an augmented reality (AR) navigation system based on preoperative CT and MRI imaging for use in endoscopic surgery for pediatric tumors. METHODS: The patients preoperatively underwent either CT or MRI with body surface markers...
December 2013: Journal of Pediatric Surgery
Yoshihiro Mise, Keigo Tani, Taku Aoki, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Yasuhiko Sugawara, Norihiro Kokudo
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...
February 2013: Journal of Hepato-biliary-pancreatic Sciences
Mariken Zijlmans, Thomas Langø, Erlend Fagertun Hofstad, Christiaan F P Van Swol, Anna Rethy
BACKGROUND: Precise laparoscopic liver resection requires accurate planning and visualization of important anatomy such as vessels and tumors. Combining laparoscopic ultrasound with navigation technology could provide this. Preoperative images are valuable for planning and overview of the procedure, while intraoperative images provide an updated view of the surgical field. PURPOSE: To validate the accuracy of navigation technology based on preoperative images, we need to understand how much the liver shifts and deforms due to heartbeat, breathing, surgical manipulation and pneumoperitoneum...
May 2012: Minimally Invasive Therapy & Allied Technologies: MITAT
N Shevchenko, J Schwaiger, M Markert, W Flatz, Tim C Lueth
A formerly developed ultrasound liver phantom for testing of surgical navigation systems and liver resection trainings was evaluated experimentally. The phantom was scanned with CT and the dataset was analyzed with existing segmentation techniques. A virtual 3D model was generated on the basis of the segmentation; it was later used for phantom registration in a surgical assistance navigation system. Within an experiment, ten test persons have tried to touch three tumor models hidden in the phantom with the tip of a resection instrument...
2011: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
R Bale, G Widmann, W Jaschke
Resection and thermal ablation procedures are frequently used for the treatment of primary and secondary liver tumors. Various tools for the virtual planning of liver resections and ablation are available and some of them are already used clinically. Resection planes and ablation volumes can be optimized for sufficient safety margins while preserving a maximal amount of functional liver tissue. Connecting the pre-operative planning with intraoperative guidance based on the 3D imaging data would be desirable...
October 2011: Minerva Chirurgica
Francesco Volonté, François Pugin, Pascal Bucher, Maki Sugimoto, Osman Ratib, Philippe Morel
BACKGROUND: New technologies can considerably improve preoperative planning, enhance the surgeon's skill and simplify the approach to complex procedures. Augmented reality techniques, robot assisted operations and computer assisted navigation tools will become increasingly important in surgery and in residents' education. METHODS: We obtained 3D reconstructions from simple spiral computed tomography (CT) slides using OsiriX, an open source processing software package dedicated to DICOM images...
July 2011: Journal of Hepato-biliary-pancreatic Sciences
Shinichi Ueno, Masahiko Sakoda, Hiroshi Kurahara, Satoshi Iino, Koji Minami, Kei Ando, Yukou Mataki, Kosei Maemura, Sumiya Ishigami, Koji Takumi, Yoshihiko Fukukura, Shoji Natsugoe
BACKGROUND/AIMS: It is important to minimize surgical invasiveness in the therapy of patients with hepatocellular carcinoma (HCC) complicated with cirrhosis. Laparoscopic hepatectomy is feasible for such patients. However, most procedures undertaken at the present time are non-anatomic partial resection or limited resection, except for left hepatectomy and bisegmentectomy 2 and 3. Because anatomic hepatic resection for small HCC yielded more favorable results than non-anatomic resection, we conducted laparoscopic anatomic hepatic resection as image-navigated surgery by referring to portal 3D images...
July 2010: Hepato-gastroenterology
S S Chopra, R M Eisele, T Denecke, M Stockmann, T Lange, S Eulenstein, S C Schmidt, P Neuhaus
Technological developments, advances in perioperative medicine and ongoing scientific research have led to reduced rates of mortality and morbidity in patients undergoing major liver surgery. Under these conditions, the frontier of resectability is constantly in movement towards more complex cases with extended tumor spread and potentially minimized remnant liver volume. A promising technique to support oncological correct and safe liver surgery is the introduction of preoperative computer based planning models and intraoperative navigation systems...
August 2010: Minerva Chirurgica
Oleg Heizmann, Stephan Zidowitz, Holger Bourquain, Silke Potthast, Heinz-Otto Peitgen, Daniel Oertli, Christoph Kettelhack
BACKGROUND: The implementation of intraoperative navigation in liver surgery is handicapped by intraoperative organ shift, tissue deformation, the absence of external landmarks, and anatomical differences in the vascular tree. To investigate the impact of surgical manipulation on the liver surface and intrahepatic structures, we conducted a prospective clinical trial. METHODS: Eleven consecutive patients [4 female and 7 male, median age = 67 years (range = 54-80)] with malignant liver disease [colorectal metastasis (n = 9) and hepatocellular cancer (n = 2)] underwent hepatic resection...
August 2010: World Journal of Surgery
Pablo Lamata, Félix Lamata, Valentin Sojar, Piotr Makowski, Laurent Massoptier, Sergio Casciaro, Wajid Ali, Thomas Stüdeli, Jérôme Declerck, Ole Jakob Elle, Ole Jackov Elle, Bjørn Edwin, Björn Edwin
BACKGROUND: The objective of this work is to evaluate a new concept of intraoperative three-dimensional (3D) visualization system to support hepatectomy. The Resection Map aims to provide accurate cartography for surgeons, who can therefore anticipate risks, increase their confidence and achieve safer liver resection. METHODS: In an experimental prospective cohort study, ten consecutive patients admitted for hepatectomy to three European hospitals were selected...
September 2010: Surgical Endoscopy
Gang Chen, Xue-cheng Li, Guo-qing Wu, Yi Wang, Bin Fang, Xiao-feng Xiong, Ri-gao Yang, Li-wen Tan, Shao-xiang Zhang, Jia-hong Dong
OBJECTIVE: To develop a technique for converting computed tomography (CT) data into a fully three-dimensional (3D) virtual reality (VR) environment. Preoperative simulation in 3D VR facilitates liver resection owing to the ability to view the tumor and its relative vessels. METHODS: 3D-reconstruction of the liver was restored from spiral CT data by using LiVirtue software and the Dextrobeam (Volume Interactions Pte Ltd, Singapore) was applied to view this 3D model in the VR environment...
2010: International Journal of Surgery
Benoit Dagon, Charles Baur, Vincent Bettschart
Efficient computer assisted surgery dealing with soft tissues remains a complex task. In most cases, the preoperative information such as 3D organ reconstructions and the planning built upon are no longer valid during the surgical process itself due to the deformations of the organ of interest. In this article, we describe the foundation parts of a framework that enables updating preoperative 3D models with intraoperative measurements in case of liver resection. The technique can be summarized as follows. During the planning stage, the discrete skeleton of hepatic veins is created out of the CT-reconstruction...
2008: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
D Wilhelm, H Feussner
Laparoscopic ultrasound exploration has significantly augmented the range of minimally invasive surgery. In particular it is essential for 3D exploration of the abdomen for staging. Beyond its diagnostic, purposes laparoscopic ultrasound is gaining importance for intraoperative therapeutic support, e. g. imaging of the biliary tree during laparoscopic surgery of the bile duct and for navigation during radio-frequency ablative or resective interventions on the liver and other parenchymatous organs. Compared to other imaging procedures, sonography has still the highest potential for further development...
May 2007: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
L Grenacher, M Thorn, H P Knaebel, M Vetter, P Hassenpflug, T Kraus, H P Meinzer, M W Büchler, G W Kauffmann, G M Richter
Cross-sectional imaging based on navigation and virtual reality planning tools are well-established in the surgical routine in orthopedic surgery and neurosurgery. In various procedures, they have achieved a significant clinical relevance and efficacy and have enhanced the discipline's resection capabilities. In abdominal surgery, however, these tools have gained little attraction so far. Even with the advantage of fast and high resolution cross-sectional liver and pancreas imaging, it remains unclear whether 3D planning and interactive planning tools might increase precision and safety of liver and pancreas surgery...
September 2005: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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