[Current Situations and Prospects of Preoperative 3D Simulation in Gastrointestinal Surgery]

Recently, three-dimensional(3D)simulation in liver surgery has become common in Japan because it is covered by medical insurance. The benefits of 3D simulation for liver surgery, such as an enhanced understanding of tumor anatomy, estimation of liver volume and assessment of irrigation area, have been previously reported. However, in the conventional system, the reconstructed 3D liver model is fixed and rigid. In addition, we were not able to observe every moment of cutting or the intrahepatic vessels. Therefore, we have developed a novel real-time virtual hepatectomy simulation software program, Liversim, to present the real-time motion and deformation of the liver. Recently, the usefulness of 3D-printed organ models based on preoperative computed tomography(CT)for hepatectomy has been reported. We have developed a novel 3D-printed liver frame model for hepatectomy, which made the procedure easier, reduced the production cost, and improved the visibility. Recently, indocyanine green(ICG)has been used for surgical navigations because it emits fluorescence upon exposure to near-infrared illumination. In addition, research and development of real-time navigation surgery like car navigation is expected.