Digital medical technology based on 64-slice computed tomography in hepatic surgery.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Fang
Chi-hua
CH
Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, No. 253, Central Industrial Road, Guangzhou, Guangdong 510282, China. fangch_dr@126.com
Huang
Yan-peng
YP
Chen
Mian-ling
ML
Lu
Chao-min
CM
Li
Xiao-feng
XF
Qiu
Wen-feng
WF
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*