Laparoscopic Liver Surgery Guided by Virtual Real-time CT-Guided Volume Navigation

Background Recently, virtual navigation system has been applied to hepatic surgery, enabling better visualization of intrahepatic vascular branches and location of tumor. Intraoperative ultrasonography (IOUS) is the most common form of image guidance during liver surgery. However, during laparoscopi...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2021-07, Vol.25 (7), p.1779-1786
Main Authors: Aoki, Takeshi, Mansour, Doaa A., Koizumi, Tomotake, Wada, Yusuke, Enami, Yuta, Fujimori, Akira, Kusano, Tomokazu, Matsuda, Kazuhiro, Nogaki, Koji, Tashiro, Yoshihiko, Hakozaki, Tomoki, Shibata, Hideki, Tomioka, Kodai, Hirai, Takahito, Yamazaki, Tatsuya, Saito, Kazuhiko, Goto, Satoru, Watanabe, Makoto, Otsuka, Koji, Murakami, Masahiko
Format: Article
Language:English
Subjects:
Ablation
Biopsy
Gastroenterology
Hepatectomy
Humans
Laparoscopy
Liver
Liver - diagnostic imaging
Liver - surgery
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - surgery
Medicine
Medicine & Public Health
Navigation systems
Original Article
Patients
Reproducibility of Results
Simulation
Surgeons
Surgery
Surgery, Computer-Assisted
Surgical apparatus & instruments
Surgical outcomes
Tomography, X-Ray Computed
Ultrasonic imaging
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Summary:Background Recently, virtual navigation system has been applied to hepatic surgery, enabling better visualization of intrahepatic vascular branches and location of tumor. Intraoperative ultrasonography (IOUS) is the most common form of image guidance during liver surgery. However, during laparoscopic hepatectomies (LH), IOUS has several limitations and its reliability has been poorly evaluated. The objective of this work is to evaluate VRCT (virtual real-time CT-guided volume navigation) during LH. This system aims to provide accurate anatomical orientation for surgeons enhancing the safety of LH. Methods Twenty-seven hepatic neoplasms were resected laparoscopically at our institution under reference guidance of VRCT. During operation, electromagnetic tracking of the surgical instrument was used for navigating the direction of accurate liver transection. Results Twenty-six (96.3%) of the 27 lesions (mean diameter 11 mm) were successfully performed under VRCT guidance. Average registration time was
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-020-04784-3