3-D reconstruction in liver surgery: a systematic review

Area of Science:

• Medical Imaging
• Surgical Planning
• Hepatobiliary Surgery

Background:

• Three-dimensional (3-D) reconstruction of the liver provides significant benefits for surgeons.
• It is utilized both before and during liver resection procedures.
• This review explores the driving factors behind the adoption of liver 3-D reconstruction.

Purpose of the Study:

• To review the factors influencing the use of 3-D liver reconstruction in surgical practice.
• To assess the impact of 3-D liver reconstruction on liver surgery outcomes.
• To synthesize current evidence on the application of 3-D liver models in hepatectomy and transplantation.

Main Methods:

• A systematic electronic literature search was conducted adhering to PRISMA criteria up to October 2023.
• Articles were selected based on their relevance to 3-D liver reconstruction and its application in liver surgery.
• Study quality was evaluated using the GRADE methodology and the modified Newcastle-Ottawa scale.

Main Results:

• The analysis encompassed 47 articles involving 7724 patients.
• Preoperative planning using 3-D liver reconstruction was employed in 87.2% of studies, primarily for complex or major hepatectomies (64.3%).
• Improved navigation and accuracy during resection were reported in 55.3% of studies. 3-D reconstruction also proved useful in living donor liver transplantation (LDLT) for graft selection and vascular preservation, and for accurate future liver remnant (FLR) measurement.

Conclusions:

• Liver 3-D reconstruction is a valuable tool for surgical planning in liver surgery.
• It is particularly beneficial for liver graft procedures and complex liver resections.
• The technology enhances the accuracy of surgical resections.