How could we image the future in hepatic surgery

Belghiti, Jacques

doi:10.21037/hbsn.2015.12.07

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Such models need to be accessible via a usable tool for surgery planning. To achieve a more accurate and comprehensive prediction of the functional capacity for Systems Surgery, several medical and computational challenges have to be resolved (Belghiti, 2016 ).…”

Section: Vision: Systems Surgery Of the Livermentioning

confidence: 99%

Computational Modeling in Liver Surgery

et al. 2017

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The need for extended liver resection is increasing due to the growing incidence of liver tumors in aging societies. Individualized surgical planning is the key for identifying the optimal resection strategy and to minimize the risk of postoperative liver failure and tumor recurrence. Current computational tools provide virtual planning of liver resection by taking into account the spatial relationship between the tumor and the hepatic vascular trees, as well as the size of the future liver remnant. However, size and function of the liver are not necessarily equivalent. Hence, determining the future liver volume might misestimate the future liver function, especially in cases of hepatic comorbidities such as hepatic steatosis. A systems medicine approach could be applied, including biological, medical, and surgical aspects, by integrating all available anatomical and functional information of the individual patient. Such an approach holds promise for better prediction of postoperative liver function and hence improved risk assessment. This review provides an overview of mathematical models related to the liver and its function and explores their potential relevance for computational liver surgery. We first summarize key facts of hepatic anatomy, physiology, and pathology relevant for hepatic surgery, followed by a description of the computational tools currently used in liver surgical planning. Then we present selected state-of-the-art computational liver models potentially useful to support liver surgery. Finally, we discuss the main challenges that will need to be addressed when developing advanced computational planning tools in the context of liver surgery.

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Section: Vision: Systems Surgery Of the Livermentioning

confidence: 99%

Computational Modeling in Liver Surgery

et al. 2017

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“…Medicine and surgery are fields in continuous and rapid evolution driven by developments in technology. In the future, as has happened for laparoscopic surgery, technical developments will help in overcoming the present limitations of delivering robotic surgery in the field of liver surgery [7]. Surgery will continue to have a significant role in the treatment of HCC, but indications may change and surgery may become part of a combined treatment approach where novel oncological agents and interventional radiology may have a greater role in curative strategies.…”

Section: The Trainee Surgeonmentioning

confidence: 99%

The Next Generation of Hepatocellular Cancer Experts: What do They Think?

et al. 2016

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“…Put simply, there is presently no ideal treatment approach. In fact, hepatic surgery has been criticized for the lack of demonstrated benefits in terms of the quality of current surgical procedures (17).…”

Section: Introductionmentioning

confidence: 99%

The efficacy of laparoscopic lauromacrogol sclerotherapy in the treatment of simple hepatic cysts located in posterior segments: a refined surgical approach

Rao

et al. 2020

Ann Palliat Med

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Background: Hepatic cysts in located posterior segments close to the diaphragm (IVa, VII, and VIII) reportedly have a high recurrence rate. Presently, laparoscopic omentoplasty is the accepted technique; developed from laparoscopic deroofing, which places a viable pedicle flap of omentum to prevent cyst closure. However, potential adhesions have made laparoscopic omentoplasty less favorable. In this paper, we report on an improved surgical technique involving lauromacrogol sclerosis directly under laparoscopic fenestration. We also review and evaluate the efficacy and feasibility of this refined surgical approach.Methods: Data from 49 patients admitted to the Department of Hepatobiliary Surgery at the Affiliated Hospital of Jiangnan University from October 2015 to June 2020 with simple hepatic cysts located in the IVa, VII, and VIII segments were retrospectively analyzed. All patients were symptomatic before admission.They were separated into two groups based on the surgical approach they had received; refined laparoscopic lauromacrogol sclerotherapy or laparoscopic omentoplasty, and were compared and evaluated in terms of the postoperative cyst volume and quality of life.Results: No significant differences in sex, age, preoperative cyst volume, surgery duration, hospital stay, and bleeding volume were reported. There were no deaths or major complications in both groups. The postoperative cyst volume was significantly reduced in the laparoscopic lauromacrogol sclerotherapy group (2.48 cm) compared to the laparoscopic omentoplasty group (3.90 cm). This study evaluated both the immediate and medium-term results with a 3-12 months follow-up period for all patients. The cyst volume change in the laparoscopic lauromacrogol sclerotherapy group was found to be significantly greater than that of the laparoscopic omentoplasty group. The feedback regarding quality of life did not vary significantly between the two groups, except for general health and health change, where patients who received laparoscopic sclerotherapy responded with higher scores. Conclusions:Our results indicate that laparoscopic lauromacrogol sclerotherapy surgery was safe and effective in patients with IVa, VII and VIII segment simple hepatic cysts.

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How could we image the future in hepatic surgery

Cited by 5 publications

References 5 publications

Computational Modeling in Liver Surgery

Computational Modeling in Liver Surgery

The Next Generation of Hepatocellular Cancer Experts: What do They Think?

The efficacy of laparoscopic lauromacrogol sclerotherapy in the treatment of simple hepatic cysts located in posterior segments: a refined surgical approach

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