Use of the Resection Map system as guidance during hepatectomy

TY - JOUR

T1 - Use of the Resection Map system as guidance during hepatectomy

AU - Lamata de la Orden, Pablo

AU - Lamata, Félix

AU - Sojar, Valentin

AU - Makowski, Piotr

AU - Massoptier, Laurent

AU - Casciaro, Sergio

AU - Ali, Wajid

AU - Stüdeli, Thomas

AU - Declerck, Jérôme

AU - Elle, Ole Jakob

AU - Elle, Ole Jackov

AU - Edwin, Bjørn

AU - Edwin, Björn

PY - 2010/9

Y1 - 2010/9

N2 - 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. Liver structures (portal veins, hepatic veins, tumours and parenchyma) were segmented from a recent computed tomography (CT) study of each patient. The surgeon planned the resection preoperatively and read the Resection Map as reference guidance during the procedure. Objective (amount of bleeding, tumour resection margin and operating time) and subjective parameters were retrieved after each case.RESULTS: Three different surgeons operated on seven patients with the navigation aid of the Resection Map. Veins displayed in the Resection Map were identified during the surgical procedure in 70.1% of cases, depending mainly on size. Surgeons were able to track resection progress and experienced improved orientation and increased confidence during the procedure.CONCLUSIONS: The Resection Map is a pragmatic solution to enhance the orientation and confidence of the surgeon. Further studies are needed to demonstrate improvement in patient safety.

AB - 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. Liver structures (portal veins, hepatic veins, tumours and parenchyma) were segmented from a recent computed tomography (CT) study of each patient. The surgeon planned the resection preoperatively and read the Resection Map as reference guidance during the procedure. Objective (amount of bleeding, tumour resection margin and operating time) and subjective parameters were retrieved after each case.RESULTS: Three different surgeons operated on seven patients with the navigation aid of the Resection Map. Veins displayed in the Resection Map were identified during the surgical procedure in 70.1% of cases, depending mainly on size. Surgeons were able to track resection progress and experienced improved orientation and increased confidence during the procedure.CONCLUSIONS: The Resection Map is a pragmatic solution to enhance the orientation and confidence of the surgeon. Further studies are needed to demonstrate improvement in patient safety.

KW - Algorithms

KW - Colorectal Neoplasms

KW - Contrast Media

KW - Hepatectomy

KW - Humans

KW - Imaging, Three-Dimensional

KW - Liver Neoplasms

KW - Prospective Studies

KW - Software

KW - Surgery, Computer-Assisted

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

U2 - 10.1007/s00464-010-0915-3

DO - 10.1007/s00464-010-0915-3

M3 - Article

C2 - 20177937

SN - 1432-2218

VL - 24

SP - 2327

EP - 2337

JO - Surgical endoscopy

JF - Surgical endoscopy

IS - 9

ER -