Back to Search
Start Over
Real-time navigation for laparoscopic hepatectomy using image fusion of preoperative 3D surgical plan and intraoperative indocyanine green fluorescence imaging.
- Source :
-
Surgical endoscopy [Surg Endosc] 2020 Aug; Vol. 34 (8), pp. 3449-3459. Date of Electronic Publication: 2019 Nov 08. - Publication Year :
- 2020
-
Abstract
- Background: Understanding the internal anatomy of the liver remains a major challenge in anatomical liver resection. Although virtual hepatectomy and indocyanine green (ICG) fluorescence imaging techniques have been widely used in hepatobiliary surgery, limitations in their application for real-time navigation persist.<br />Objective: The aim of the present study was to evaluate the feasibility and clinical utility of the novel laparoscopic hepatectomy navigation system (LHNS), which fuses preoperative three-dimensional (3D) models with ICG fluorescence imaging to achieve real-time surgical navigation.<br />Methods: We conducted a retrospective review of clinical outcome for 64 patients who underwent laparoscopic hepatectomy from January 2018 to December 2018, including 30 patients who underwent the procedure using the LHNS (LHNS group) and 34 patients who underwent the procedure without LHNS guidance (Non-LHNS group).<br />Results: There was no significant difference in preoperative characteristics between the two groups. The LHNS group had a significantly less blood loss (285.0 ± 163.0 mL vs. 391.1 ± 242.0 mL; P = 0.047), less intraoperative blood transfusion rate (13.3% vs. 38.2%; P = 0.045), and shorter postoperative hospital stay (7.8 ± 2.1 days vs. 10.6 ± 3.8 days; P < 0.001) than the Non-LHNS group. There was no statistical difference in operative time and the overall complication rate between the two groups. The liver transection line was clearly delineated by the LHNS in 27 patients; however, the projection of boundary was unclear in 2 cases, and in 1 case, the boundary was not clearly displayed by ICG fluorescence imaging.<br />Conclusions: We developed the LHNS to address limitations of current intraoperative imaging systems. The LHNS is hopefully to become a promising real-time navigation system for laparoscopic hepatectomy.
- Subjects :
- Adult
Aged
Blood Loss, Surgical
Blood Transfusion
Carcinoma, Hepatocellular surgery
Feasibility Studies
Female
Fluorescence
Humans
Imaging, Three-Dimensional
Indocyanine Green therapeutic use
Length of Stay
Liver Neoplasms surgery
Male
Middle Aged
Operative Time
Postoperative Complications
Retrospective Studies
Carcinoma, Hepatocellular diagnostic imaging
Hepatectomy methods
Laparoscopy methods
Liver Neoplasms diagnostic imaging
Optical Imaging methods
Surgery, Computer-Assisted methods
Surgical Navigation Systems
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 34
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 31705286
- Full Text :
- https://doi.org/10.1007/s00464-019-07121-1