Use of the Resection Map system as guidance during hepatectomy.
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.
Lamata
Pablo
P
Siemens Molecular Imaging, Oxford, UK, Pablo.lamata@hotmail.com.
Lamata
Félix
F
Sojar
Valentin
V
Makowski
Piotr
P
Massoptier
Laurent
L
Casciaro
Sergio
S
Ali
Wajid
W
Stüdeli
Thomas
T
Declerck
Jérôme
J
Elle
Ole Jakob
OJ
Elle
Ole Jackov
OJ
Edwin
Bjørn
B
Edwin
Björn
B
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
D003287:Contrast Media