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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
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.
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.
