Essential updates 2020/2021: Current topics of simulation and navigation in hepatectomy

Abstract

Advances in perioperative care and surgical techniques have significantly improved the outcomes of liver resection during the last three decades. Liver surgery has inherent challenges, including difficult anticipation of complex and variable intrahepatic anatomy and the need for cognitive analysis by the surgeon to integrate preoperative imaging information into the operative field. Therefore, simulation and navigation techniques have been developed in this field.In preoperative simulation, three-dimensional (3D) simulation technology was developed in Germany in the early 2000s, 1 and immediately thereafter software based on an original algorithm was developed in Japan. The development of intraoperative navigation techniques may also help surgeons to perform liver resections as planned. Intraoperative navigation began with intraoperative ultrasound (US) in 1980 2 and progressed to virtual hepatectomy (Hx), [3][4][5][6][7] real-time virtual sonography, 8-12 and finally indocyanine green (ICG) fluorescence. [13][14][15][16][17][18][19][20] Thus, intraoperative navigation has gradually evolved during the past 40 y. This biannual review discusses the essential updates to simulation and navigation in Hx that occurred in the 2-y period from 2020 to 2021. | PREOPER ATIVE S IMUL ATIONPreoperative 3D simulation has enabled surgeons to obtain a great deal of information, such as detailed anatomical visualization, the

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Laparoscopic Anatomical Segment 5 Resection for Hepatocellular Carcinoma Using the Glissonian Approach with Indocyanine Green Dye Fluorescence and Ultrasound guidance

“…Fluorescence staining will be helpful for complete resection of the Glisson system in di cult liver segments and high-quality exposure of the interwatershed veins. Adhere to the concept of river basin anatomical liver resection, implement the complete resection of the tumorbearing Glison system, and pursue long-term oncology and short-term perioperative e cacy, implement the consensus of international experts to the end, and carry out the MIALR concept to the extreme [22] .…”

Evaluation and Prediction of Post-Hepatectomy Liver Failure Using Imaging Techniques: Value of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging

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