Real-time Navigation for Liver Surgery Using Projection Mapping With Indocyanine Green Fluorescence: Development of the Novel Medical Imaging Projection System.
The aim of the present study was to evaluate the usefulness of a new imaging device, the Medical Imaging Projection System (MIPS), which uses the indocyanine green emission signal and active projection mapping, for liver resection.



During anatomic liver resection, surgeons cannot completely view the intraparenchymal structure. Although a fluorescent imaging technique using indocyanine green has recently been developed for hepatobiliary surgery, limitations in its application for real-time navigation persist.



We conducted a retrospective review of surgical and clinical outcomes for 23 patients who underwent anatomic hepatectomy using the MIPS and 29 patients who underwent the procedure without MIPS guidance, between September 2014 and September 2015.



Preoperative characteristics were comparable between the 2 groups. No significant between-group differences were identified with regard to surgical and clinical outcomes. The demarcation lines were clearly projected by the MIPS in 21 patients; however, the boundary line was undetectable in 2 patients.



We developed the MIPS to address limitations in current intraoperative imaging methods. Our retrospective analysis provides evidence of the feasibility and clinical utility of the MIPS to identify anatomical landmarks for parenchymal dissection. The MIPS holds promise as a novel real-time navigation system for liver resection.
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroto
H
Nishino
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
Etsuro
E
Hatano
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Satoru
S
Seo
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Department of Surgery, Mitsubishi Kyoto Hospital, Kyoto, Japan.
Takashi
T
Nitta
Panasonic AVC Networks Company, Osaka, Japan.
Tomoyuki
T
Saito
Panasonic AVC Networks Company, Osaka, Japan.
Masaaki
M
Nakamura
Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
Kayo
K
Hattori
Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
Muneo
M
Takatani
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroaki
H
Fuji
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kojiro
K
Taura
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Shinji
S
Uemoto
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery; D005456:Fluorescent Dyes; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007208:Indocyanine Green; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D061848:Optical Imaging / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D005456:Fluorescent Dyes; D007208:Indocyanine Green