ABSTRACT
<p><b>BACKGROUND</b>With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery.</p><p><b>METHODS</b>Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.</p><p><b>RESULTS</b>The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.</p><p><b>CONCLUSIONS</b>Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Liver , Diagnostic Imaging , General Surgery , Tomography, X-Ray Computed , MethodsABSTRACT
<p><b>OBJECTIVE</b>To study the value of digital medical technology in diagnosis and treatment of the hepatolithiasis.</p><p><b>METHODS</b>64-slice spiral computer tomography (CT) scan data of 14 cases (11 female, 3 male; median age, 48 years) with hepatolithiasis admitted from February to September 2008 were collected. The data were imported into medical image proceeding system (MIPS) for sequence segmenting and three-dimensional (3D) reconstruction. The reconstructed models were imported into FreeForm Modeling System for performing simulation surgery with simulation surgical instruments. According to the results of 3D reconstruction and simulation surgery, reasonable operation strategies were chosen. Finally, the value of clinical application of simulation surgery was evaluated according to the findings of clinical operation on hepatolithiasis patients and postoperative T-tube angiography.</p><p><b>RESULTS</b>The 3D reconstructed models of 14 cases with hepatolithiasis revealed 7 cases of left liver hepatolithiasis, 2 cases of right liver hepatolithiasis, 5 cases of bilateral hepatolithiasis, including 6 cases of hepatolithiasis with common bile duct calculi, 6 cases of biliary system models with absolute stricture, 8 cases with relative stricture. The results were of agreement with clinical diagnosis. A variety of operation plans were simulated before operation. Simulation equipment used in process of simulation surgery was a powerful sense of feedback.</p><p><b>CONCLUSIONS</b>Digital medical technology is helpful to understand the calculi distribution, bile ducts stricture and deformity. Through preoperative training, simulation surgery are able to guide for choosing operative strategies. It reduces the operation risks.</p>