title: Use of the Resection Map system as guidance during hepatectomy.
abstract: 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.
authors.affiliation: Siemens Molecular Imaging, Oxford, UK, Pablo.lamata@hotmail.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lamata
authors.forename: Félix
authors.initials: F
authors.lastname: Lamata
authors.forename: Valentin
authors.initials: V
authors.lastname: Sojar
authors.forename: Piotr
authors.initials: P
authors.lastname: Makowski
authors.forename: Laurent
authors.initials: L
authors.lastname: Massoptier
authors.forename: Sergio
authors.initials: S
authors.lastname: Casciaro
authors.forename: Wajid
authors.initials: W
authors.lastname: Ali
authors.forename: Thomas
authors.initials: T
authors.lastname: Stüdeli
authors.forename: Jérôme
authors.initials: J
authors.lastname: Declerck
authors.forename: Ole Jakob
authors.initials: OJ
authors.lastname: Elle
authors.forename: Ole Jackov
authors.initials: OJ
authors.lastname: Elle
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
authors.forename: Björn
authors.initials: B
authors.lastname: Edwin
mesh_terms: D000465:Algorithms; D015179:Colorectal Neoplasms / Q000473:pathology; D003287:Contrast Media; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D011446:Prospective Studies; D012984:Software; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media