Die verschwundene Lebermetastase – Neues Einsatzgebiet für die computerassistierte 3D-navigierte laparoskopische Leberesektion?

Huber, Tobias; Baumgart, J.; Peterhans, Matthias; Weber, Stefan; Heinrich, Stefan; Lang, Hauke

doi:10.1055/s-0041-107542

Cited by 12 publications

(4 citation statements)

References 5 publications

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“…Valid data on this technology are missing, but the currently available literature suggests higher blood loss and longer operating time for robotic surgery. In addition, the cost of this technology still outrages those of laparoscopic surgery [38], [39], [40]. It is anticipated, however, that future developments in robotic surgery will overcome these shortcomings of robotic technology.…”

Section: Future Developmentsmentioning

confidence: 99%

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Hepatic resection for primary and secondary liver malignancies

Heinrich

Lang

2017

Innovative Surgical Sciences

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Liver surgery has become the standard treatment of primary liver cancer and liver metastases from colorectal cancer. Also, patients with non-colorectal liver metastases are increasingly offered surgery due to the low morbidity and excellent long-term results. The evolution of two-stage procedures helps to increase resectability. Also, laparoscopic and robotic liver surgery are constantly developed.

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Section: Future Developmentsmentioning

confidence: 99%

“…This technology helps the intraoperative orientation, as the resection is simulated in the actual computed tomography (CT) images. The relation to major vessels can be anticipated online, and even diminished liver metastases can be safely resected with the parenchyma sparing technique [40].…”

Section: Future Developmentsmentioning

confidence: 99%

Hepatic resection for primary and secondary liver malignancies

Heinrich

Lang

2017

Innovative Surgical Sciences

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“…In the literature, evidence for the use of this type navigated liver surgery is scarce and there are only few case series regarding navigation systems in liver surgery so far. These previous studies on the used soft tissue navigation system describe the first implementation of the system, the definition of use cases and focus on registration methods and accuracy ( 8 - 12 ).…”

Section: Introductionmentioning

confidence: 99%

Computer-assisted intraoperative 3D-navigation for liver surgery: a prospective randomized-controlled pilot study

Huber,

Tripke,

Baumgart

et al. 2023

Ann Transl Med

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Background Liver surgery is the standard of care for primary and many secondary liver tumors. Due to variability and complexity in liver anatomy preoperative imaging is necessary to determine resectability and for planning the surgical strategy. In the last few years, computer-assisted resection planning has been introduced in liver surgery. Aim of this trial was the evaluation of computer-assisted three-dimensional (3D)-navigation for liver surgery. Methods This study was a prospective randomized-controlled pilot trial and patients were randomized in navigated or non-navigated group. Primary end point was the quotient of intraoperative resected volume and planned resection volume. Secondary end points included operation time, resection margin and postoperative complications. 3D reconstructions were performed with MeVis Distant Services (MeVis AG, Bremen, Germany). The navigation system CAS-One Liver (CAScination AG, Bern, Switzerland) was used for intraoperative computer-assisted 3D-navigation. Results The data of 16 patients with 20 liver tumors were used in this analysis. Of these, 8 liver tumors were resected with the utilization of intraoperative navigation. Two postoperative complications were classified grade IIIa or higher. There was no difference in duration of operation (189 vs. 180 min, P=0.970), rate of postoperative complications (n=1 vs. n=1, P=0.696) and length of hospital stay (9 vs. 7 days, P=0.368) between the two groups. Minimal resection margin (0.15 vs. 0.40 cm, P=0.384) and quotient of planned to intraoperative resection volume (0.94 vs. 1.11, P=0.305) were also similar. Conclusions Intraoperative navigation is a technology that can be safely used during liver resection. Surgical accuracy is not yet superior to the current standard of intraoperative orientation. Further technological advances with suitable deformation algorithms and augmented reality systems will enable a further improvement of the technical feasibility.

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“…Three-dimensional liver reconstruction is a useful tool for visualizing critical structures for surgical planning and intraoperative orientation [3,4]. Furthermore, it is the basis for three-dimensional printing and computer-assisted navigation [5,6].…”

Section: Introductionmentioning

confidence: 99%

Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense

Paschold

Huettl

Kneist

et al. 2020

Langenbecks Arch Surg

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Purpose In hepatobiliary surgery, preoperative three-dimensional reconstruction based on CT or MRI can be provided externally or by local, semi-automatic software. We analyzed the time expense and quality of external versus local three-dimensional reconstructions. Methods Three first-year residents reconstructed data from 20 patients with liver pathologies using a local, semi-automatic, server-based program. Initially, five randomly selected patient datasets were segmented, with the visualization of an established external company available for comparison at all times (learning phase). The other fifteen cases were compared with the external datasets after completing local reconstruction (control phase). Total time expense/case and for specific manual and semiautomated reconstruction steps were recorded. Segmentation quality was analyzed by testing the equivalence for liver and tumor volumes, portal vein sectors, and hepatic vein territories. Results The median total reconstruction time was reduced from 2.5 h (learning phase) to 1.5 h (control phase) (− 42%; p < 0.001). Comparing the total and detailed liver volumes (sectors and territories) as well as the tumor volumes in the control phase equivalence was proven. In addition, a highly significant correlation between the external and local analysis was obtained over all analyzed segments with a very high ICC (median [IQR]: 0.98 [0.97; 0.99]; p < 0.01). Conclusion Local, semi-automatic reconstruction performed by inexperienced residents was feasible with an expert level time expense and the quality of the three-dimensional images was comparable with those from an external provider.

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Die verschwundene Lebermetastase – Neues Einsatzgebiet für die computerassistierte 3D-navigierte laparoskopische Leberesektion?

Cited by 12 publications

References 5 publications

Hepatic resection for primary and secondary liver malignancies

Hepatic resection for primary and secondary liver malignancies

Computer-assisted intraoperative 3D-navigation for liver surgery: a prospective randomized-controlled pilot study

Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense

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