Fang C H, Zhang P, Lau Y Y, Zhong S Z
First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University; Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou 510282, China.
Faculty of Medicine, Chinese University of Hong Kong, Hong Kong 999077, China.
Zhonghua Wai Ke Za Zhi. 2020 Jan 1;58(1):17-21. doi: 10.3760/cma.j.issn.0529-5815.2020.01.005.
Digital intelligent hepatobiliary surgery has evolved over decades.It has experienced an evolution course from digital virtual human technology to the establishment of a quality-controlled and homogeneous three-dimensional visualization system for precision diagnosis and treatment of diseases, from three-dimensional visualization to the clinical transformation of digital intelligent technology and changes in the diagnosis and treatment model, from empirical diagnosis of diseases to the application of deep learning for the intelligent diagnosis and treatment of diseases, from empirical surgery to real-time multi-modal image guidance during surgery, and from the morphological diagnosis of tumors to accurate diagnosis from molecular imaging.During the whole process, only through continuous innovation in research, theory and technology can the "life" of digital intelligent surgery be endowed with new vitality.In the future, the definition of tumor boundary from the molecular and cellular levels and the early diagnosis and treatment of liver tumor through the functional visualization of key molecules will have significant clinical value for changing the prognosis of liver cancer.In addition, in order to realize intelligent navigation for hepatectomy and break through the technical bottleneck, it is of great clinical significance to develop an intelligent robot real-time navigation hepatectomy system with automatic navigation technology, machine learning intelligent planning technology and multimodal image fusion technology.This provides unprecedented opportunities and challenges for the development of digital intelligent hepatobiliary surgery.
数字智能肝胆外科历经数十年发展。它经历了从数字虚拟人体技术到建立用于疾病精准诊断和治疗的质量可控且同质化的三维可视化系统的演进过程,从三维可视化到数字智能技术的临床转化以及诊疗模式的变革,从疾病的经验性诊断到应用深度学习进行疾病的智能诊疗,从经验性手术到手术中的实时多模态影像引导,从肿瘤的形态学诊断到分子影像的精准诊断。在整个过程中,只有通过研究、理论和技术的不断创新,才能赋予数字智能手术的“生命”新的活力。未来,从分子和细胞水平定义肿瘤边界以及通过关键分子的功能可视化实现肝肿瘤的早期诊断和治疗,对于改变肝癌的预后具有重要的临床价值。此外,为实现肝切除术的智能导航并突破技术瓶颈,开发具有自动导航技术、机器学习智能规划技术和多模态影像融合技术的智能机器人实时导航肝切除术系统具有重大临床意义。这为数字智能肝胆外科的发展提供了前所未有的机遇和挑战。