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Related Experiment Video

Updated: Jan 8, 2026

Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
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A Widely Applicable CAD-Based Intraoperative 3D Navigation Method for Hepatopancreatobiliary Surgery.

Ryota Ito1,2, Atsushi Oba3, Hayato Baba1

  • 1Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.

Annals of Surgical Oncology
|December 17, 2025
PubMed
Summary

This study introduces a new, low-cost method for intraoperative navigation in hepato-pancreato-biliary (HPB) surgery using computer-aided design (CAD). The CAD approach significantly reduces creation time compared to traditional diagrams, enhancing surgical planning and efficiency.

Keywords:
Anatomical visualizationCADComputer-aided designHepato-pancreato-biliary surgeryIntraoperative navigationRobotic pancreatectomyRobotic surgerySurgical educationThree-dimensional imaging

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Area of Science:

  • Hepato-pancreato-biliary (HPB) surgery
  • Surgical Navigation
  • Medical Imaging

Background:

  • Precise anatomic understanding is critical in hepato-pancreato-biliary (HPB) surgery.
  • While 3D imaging aids preoperative planning, real-time intraoperative navigation systems are lacking.
  • Traditional schematic diagrams are time-consuming and lack detail.

Purpose of the Study:

  • To develop and evaluate a simple, low-cost intraoperative 3D navigation method for HPB surgery.
  • To compare the efficiency of computer-aided design (CAD) models with traditional schematic diagrams.
  • To assess the potential for widespread adoption and educational value of CAD-based navigation.

Main Methods:

  • Analyzed 32 HPB cases (January-August 2025).
  • Reconstructed 3D images from CT data using REVORAS.
  • Created schematic diagrams with Procreate and CAD models with Fusion 360 and Shapr3D.
  • Measured and compared the creation times for both methods.

Main Results:

  • Computer-aided design (CAD) models were created significantly faster (median 7 min 25 s) than schematic diagrams (median 19 min 48 s) (p < 0.01).
  • CAD models facilitated real-time anatomic information sharing via tablets integrated with the da Vinci Surgical System.
  • Surgical approaches included open, robotic, and laparoscopic procedures for pancreatic, hepatic, and sarcoma resections.

Conclusions:

  • Intraoperative navigation using computer-aided design (CAD) is a simple, cost-effective, and time-efficient solution for HPB surgery.
  • This method shows strong potential for broad adoption in clinical practice.
  • CAD-based navigation offers significant educational benefits for HPB surgeons.