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Laparoscopic Liver Surgery Guided by Virtual Real-time CT-Guided Volume Navigation.
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.
Afiliación
  • Aoki T; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. takejp@med.showa-u.ac.jp.
  • Mansour DA; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Koizumi T; General Surgery Department, Cairo University Hospitals, Kasr Alainy, Al-Saray Street, El-Manial, Cairo, 11956, Egypt.
  • Wada Y; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Enami Y; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Fujimori A; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Kusano T; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Matsuda K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Nogaki K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Tashiro Y; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Hakozaki T; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Shibata H; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Tomioka K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Hirai T; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Yamazaki T; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Saito K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Goto S; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Watanabe M; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Otsuka K; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
  • Murakami M; Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
J Gastrointest Surg ; 25(7): 1779-1786, 2021 07.
Article en En | MEDLINE | ID: mdl-32901425
ABSTRACT

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 < 2 min. Average setup time was approximately 7 min per procedure. VRCT allows the surgeon to navigate liver transection with acceptable accuracy. The mean error was 12 mm. All surgical margins were negative and the mean histologic resection margin was 9 mm.

CONCLUSIONS:

VRCT-guided LH is feasible and provides valuable real-time anatomical feedback during hepatic resections. Advancement of such systems to improve accuracy might greatly compensate for the limitation of laparoscopic IOUS.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Laparoscopía / Cirugía Asistida por Computador / Neoplasias Hepáticas Límite: Humans Idioma: En Año: 2021 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Laparoscopía / Cirugía Asistida por Computador / Neoplasias Hepáticas Límite: Humans Idioma: En Año: 2021 Tipo del documento: Article