Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, TR-35100, Izmir, Turkey.
Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey.
Surg Radiol Anat. 2021 Aug;43(8):1359-1371. doi: 10.1007/s00276-021-02724-7. Epub 2021 Mar 7.
Primary aspect of hepatic navigation surgery is the identification of source vascular details to preserve healthy liver which has a vascular anatomy quite challenging for the young surgeons. The purpose was to determine whether three-dimensional (3D) vascular pattern models of preoperative computed tomography (CT) images will assist resident-level trainees for hepatic surgery.
This study was based on the perception of residents who were presented with 5 different hepatic source vascular patterns and required to compare their perception level of CT, and 1:1 models in terms of importance of variability, differential of patterns and preoperative planning.
All residents agree that models provided better understanding of vascular source and improved preplanning. Five stations provided qualitative assessment with results showing the usefulness of porta-celiac models when used as anatomical tools in preplanning (p = 0.04), simulation of interventional procedures (p = 0.02), surgical education (p = 0.01). None of the cases had scored less than 8.5. Responses related to understanding variations were significantly higher in the perception of the 3D model in all cases, furthermore 3D models were more useful for seniors in more complex cases 3 and 5. Some open-ended answers: "The 3D model can completely change the operation plan" One of the major factors for anatomical resection of liver transplantation is the positional relationship between the hepatic arteries and the portal veins.
The plastic-like material presenting the hepatic vascularity enables the visualization of the origin, pattern, shape, and angle of the branches with appropriate spatial perception thus making it well-structured.
肝脏导航手术的主要方面是识别源血管细节以保留健康的肝脏，这对于年轻外科医生来说具有挑战性的血管解剖结构。目的是确定术前计算机断层扫描 (CT) 图像的三维 (3D) 血管模式模型是否有助于住院医师级别的肝外科手术。
本研究基于住院医师对 5 种不同肝源血管模式的感知，要求他们比较 CT 和 1:1 模型在变异性、模式差异和术前规划方面的感知水平。
所有住院医师都认为模型提供了对血管源的更好理解，并改善了术前规划。五个站点提供了定性评估，结果表明门静脉-腹腔模型在术前规划中作为解剖工具（p=0.04）、模拟介入程序（p=0.02）、外科教育（p=0.01）方面具有实用性。所有病例的评分均高于 8.5 分。在所有病例中，3D 模型对理解变异的感知明显更高，此外，3D 模型对更复杂病例 3 和 5 的高级住院医师更有用。一些开放式回答：“3D 模型可以完全改变手术计划”。肝移植解剖切除的一个主要因素是肝动脉和门静脉之间的位置关系。
呈现肝血管的塑料状材料能够可视化分支的起源、模式、形状和角度，并具有适当的空间感知，从而使其结构良好。
