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Journal of Hepato-Biliary-Pancreatic Sciences
Published in: Journal of Hepato-Biliary-Pancreatic Sciences 6/2009

01-11-2009 | Original article

Minimally invasive laparoscopic liver resection: 3D MDCT simulation for preoperative planning

Authors: Junichi Yamanaka, Toshihiro Okada, Shinichi Saito, Yuichi Kondo, Yasuhiko Yoshida, Kazuhiro Suzumura, Tadamichi Hirano, Yuji Iimuro, Jiro Fujimoto

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 6/2009

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Abstract

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.
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Metadata
Title
Minimally invasive laparoscopic liver resection: 3D MDCT simulation for preoperative planning
Authors
Junichi Yamanaka
Toshihiro Okada
Shinichi Saito
Yuichi Kondo
Yasuhiko Yoshida
Kazuhiro Suzumura
Tadamichi Hirano
Yuji Iimuro
Jiro Fujimoto
Publication date
01-11-2009
Publisher
Springer Japan
Published in
Journal of Hepato-Biliary-Pancreatic Sciences / Issue 6/2009
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI
https://doi.org/10.1007/s00534-009-0112-8

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