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Minimally invasive laparoscopic liver resection: 3D MDCT simulation for preoperative planning
Author(s) -
Yamanaka Junichi,
Okada Toshihiro,
Saito Shinichi,
Kondo Yuichi,
Yoshida Yasuhiko,
Suzumura Kazuhiro,
Hirano Tadamichi,
Iimuro Yuji,
Fujimoto Jiro
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0112-8
Subject(s) - hepatectomy , medicine , laparoscopy , resection margin , laparotomy , margin (machine learning) , resection , radiology , operation planning , surgery , surgical margin , computer science , machine learning , engineering , manufacturing engineering
Background/purpose Laparoscopic liver resection has not gained wide acceptance compared with other laparoscopic procedures. We evaluated the impact of simulated surgery using data from multidetector CT scanning on planning for laparoscopic hepatectomy. Methods The hepatectomy simulation system was programmed to perform three‐dimensional reconstruction of the vasculature and to calculate the liver resection volume and surgical margin. In 35 patients undergoing laparoscopic hepatectomy or laparoscopy‐assisted hepatectomy, the liver resection volume and margin were estimated by simulation preoperatively. Then, the estimated values were compared with the actual resected liver weight and margin. Results Three‐dimensional reconstruction allowed stereoscopic identification of the tumor‐bearing portal vein and draining vein. The predicted liver resection volume and margin both showed a significant correlation with the actual values: the mean difference was 21 mL ( P < 0.0001) and 1.3 mm ( P < 0.01), respectively. Preoperative planning based on simulated resection facilitated laparoscopic mobilization of the liver and mini‐laparotomy resection of a large tumor located in the upper right lobe. Conclusions Three‐dimensional simulation of hepatectomy facilitated intraoperative identification of the vascular anatomy, and accurately predicted the resected liver volume and surgical margin. This simulation method should contribute to preoperative planning for safe and curative laparoscopic hepatectomy.