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Erschienen in: Surgical Endoscopy 8/2020

08.11.2019

Real-time navigation for laparoscopic hepatectomy using image fusion of preoperative 3D surgical plan and intraoperative indocyanine green fluorescence imaging

verfasst von: Peng Zhang, Huoling Luo, Wen Zhu, Jian Yang, Ning Zeng, Yingfang Fan, Sai Wen, Nan Xiang, Fucang Jia, Chihua Fang

Erschienen in: Surgical Endoscopy | Ausgabe 8/2020

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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.

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.

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).

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.

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.
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Metadaten
Titel
Real-time navigation for laparoscopic hepatectomy using image fusion of preoperative 3D surgical plan and intraoperative indocyanine green fluorescence imaging
verfasst von
Peng Zhang
Huoling Luo
Wen Zhu
Jian Yang
Ning Zeng
Yingfang Fan
Sai Wen
Nan Xiang
Fucang Jia
Chihua Fang
Publikationsdatum
08.11.2019
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 8/2020
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07121-1

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