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Precision surgery and radiomics for laparoscopic liver cancer resection with intraoperative holographic 3DCT

Maki Sugimoto, MD, PhD1, Mitsuo Shimada2, Gio Wakabayashi3. 1The University of Tokyo Research Center for Advanced Science and Technology, 2Tokushima University, 3Ageo Central General Hospital

The aim of precisionliver surgery is a balance of maximizing the removal of the target lesion, while maximizing the functional liver remnant and minimizing surgical invasiveness. We evaluated the radiomics application of precision approach using intraoperative holographic CTin laparoscopic complex liver surgery.

In 3 laparoscopic liver cancer surgeries, we reconstructed the 3D polygon models of the liver segments, planned surgical margins, tumor and vessels from patient individual preoperative CT. During surgery we performed 3D-CT cholangiography directly through a cystic duct. We could watch these holographic polygons above the operative field usinf our original mixed reality application to present 3D organ models with the wearable holographic google (HoloLens). This was presented as a hologram in which the organ floats in the direction of 360 degrees around the surgeon and the space on the field of sterilized surgical field before, after, and during surgery.

As a result, in the space outside the endoscopic monitor, biliary anatomy models were corrected to the movement of the operator's eyes and hand gesture, and the stereoscopic relationship between each organ and the surgical margin, tumor position, artery, vein, bile duct, uterus, and myomas, was constantly observed from any directions.

As the spatial awarenesswas improved, the clinical usefulness was confirmed by avoiding misunderstanding in all cases. The immersive and presence feeling alleviate the stress of the surgeon and improve the accuracy, bleeding volume, and the operation time. It improved the sense of equilibrium and strengthened the space recognition ability.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95960

Program Number: P698

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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