Huber, Tobias; Tripke, Verena; Baumgart, Janine; Bartsch, Fabian; Schulze, Alicia; Weber, Stefan; Heinrich, Stefan; Lang, Hauke (2023). Computer-assisted intraoperative 3D-navigation for liver surgery: a prospective randomized-controlled pilot study. Annals of translational medicine, 11(10), p. 346. AME Publishing Company 10.21037/atm-22-5489
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BACKGROUND
Liver surgery is the standard of care for primary and many secondary liver tumors. Due to variability and complexity in liver anatomy preoperative imaging is necessary to determine resectability and for planning the surgical strategy. In the last few years, computer-assisted resection planning has been introduced in liver surgery. Aim of this trial was the evaluation of computer-assisted three-dimensional (3D)-navigation for liver surgery.
METHODS
This study was a prospective randomized-controlled pilot trial and patients were randomized in navigated or non-navigated group. Primary end point was the quotient of intraoperative resected volume and planned resection volume. Secondary end points included operation time, resection margin and postoperative complications. 3D reconstructions were performed with MeVis Distant Services (MeVis AG, Bremen, Germany). The navigation system CAS-One Liver (CAScination AG, Bern, Switzerland) was used for intraoperative computer-assisted 3D-navigation.
RESULTS
The data of 16 patients with 20 liver tumors were used in this analysis. Of these, 8 liver tumors were resected with the utilization of intraoperative navigation. Two postoperative complications were classified grade IIIa or higher. There was no difference in duration of operation (189 vs. 180 min, P=0.970), rate of postoperative complications (n=1 vs. n=1, P=0.696) and length of hospital stay (9 vs. 7 days, P=0.368) between the two groups. Minimal resection margin (0.15 vs. 0.40 cm, P=0.384) and quotient of planned to intraoperative resection volume (0.94 vs. 1.11, P=0.305) were also similar.
CONCLUSIONS
Intraoperative navigation is a technology that can be safely used during liver resection. Surgical accuracy is not yet superior to the current standard of intraoperative orientation. Further technological advances with suitable deformation algorithms and augmented reality systems will enable a further improvement of the technical feasibility.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy |
UniBE Contributor: |
Weber, Stefan (B) |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2305-5839 |
Publisher: |
AME Publishing Company |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
07 Sep 2023 15:54 |
Last Modified: |
29 Oct 2023 02:22 |
Publisher DOI: |
10.21037/atm-22-5489 |
PubMed ID: |
37675318 |
Uncontrolled Keywords: |
3D navigation Liver surgery liver tumors surgical planning three-dimensional liver reconstruction (3D liver reconstruction) |
BORIS DOI: |
10.48350/186135 |
URI: |
https://boris.unibe.ch/id/eprint/186135 |
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