Siemens Molecular Imaging, Oxford, UK,
Surg Endosc. 2010 Sep;24(9):2327-37. doi: 10.1007/s00464-010-0915-3. Epub 2010 Feb 23.
The objective of this work is to evaluate a new concept of intraoperative three-dimensional (3D) visualization system to support hepatectomy. The Resection Map aims to provide accurate cartography for surgeons, who can therefore anticipate risks, increase their confidence and achieve safer liver resection.
In an experimental prospective cohort study, ten consecutive patients admitted for hepatectomy to three European hospitals were selected. Liver structures (portal veins, hepatic veins, tumours and parenchyma) were segmented from a recent computed tomography (CT) study of each patient. The surgeon planned the resection preoperatively and read the Resection Map as reference guidance during the procedure. Objective (amount of bleeding, tumour resection margin and operating time) and subjective parameters were retrieved after each case.
Three different surgeons operated on seven patients with the navigation aid of the Resection Map. Veins displayed in the Resection Map were identified during the surgical procedure in 70.1% of cases, depending mainly on size. Surgeons were able to track resection progress and experienced improved orientation and increased confidence during the procedure.
The Resection Map is a pragmatic solution to enhance the orientation and confidence of the surgeon. Further studies are needed to demonstrate improvement in patient safety.
本研究旨在评估一种新的术中三维（3D）可视化系统，以辅助肝切除术。“切除图”旨在为外科医生提供准确的图谱，使他们能够预测风险、增加信心并实现更安全的肝切除术。
在一项实验性前瞻性队列研究中，选择了来自三个欧洲医院的连续 10 例拟行肝切除术的患者。从每位患者最近的计算机断层扫描（CT）研究中对肝脏结构（门静脉、肝静脉、肿瘤和肝实质）进行分割。外科医生在术前计划切除，并在手术过程中参考“切除图”作为参考指导。在每个病例后，检索客观（出血量、肿瘤切除边界和手术时间）和主观参数。
三位不同的外科医生在“切除图”的导航辅助下对 7 例患者进行了手术。“切除图”中显示的静脉在 70.1%的情况下可在手术过程中识别，这主要取决于静脉的大小。外科医生能够跟踪切除进度，并在手术过程中提高方向感和信心。
“切除图”是增强外科医生方向感和信心的实用解决方案。需要进一步的研究来证明患者安全性的提高。
