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Laparoscopic Liver Surgery Guided by Virtual Real-time CT-Guided Volume Navigation
Takeshi Aoki1, Doaa A Mansour2,3, Tomotake Koizumi2
1Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. takejp@med.showa-u.ac.jp.
Summary
Virtual real-time CT-guided volume navigation (VRCT) enhances safety in laparoscopic liver surgery by providing accurate anatomical orientation. This system successfully guided resections, improving visualization and aiding surgeons.
Area of Science:
- Minimally invasive surgery
- Surgical navigation systems
- Medical imaging and image-guided therapy
Background:
- Intraoperative ultrasonography (IOUS) is standard for liver surgery but has limitations in laparoscopic hepatectomies (LH).
- Virtual navigation systems offer improved visualization of intrahepatic structures and tumors during hepatic surgery.
Purpose of the Study:
- To evaluate the feasibility and accuracy of virtual real-time CT-guided volume navigation (VRCT) during laparoscopic hepatectomies (LH).
- To assess VRCT's ability to provide accurate anatomical orientation and enhance surgical safety in LH.
Main Methods:
- Twenty-seven laparoscopic liver resections were performed using VRCT guidance.
- Electromagnetic tracking of surgical instruments was employed for precise liver transection navigation.
Main Results:
- 96.3% of 27 liver lesions (mean diameter 11 mm) were successfully resected under VRCT guidance.
- The system demonstrated acceptable accuracy for liver transection navigation, with a mean error of 12 mm.
- Negative surgical margins were achieved in all cases, with a mean histologic resection margin of 9 mm.
Conclusions:
- VRCT-guided LH is a feasible approach that offers valuable real-time anatomical feedback.
- Advancements in VRCT systems can potentially overcome the limitations of laparoscopic IOUS in hepatic resections.
