The effects of real-time image navigation in operative liver surgery
The effects of real-time image navigation in operative liver surgery
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DOI：
10.1007/s11548-011-0557-5
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发表时间：
2011-11-01
影响因子：
3
通讯作者：
Lueth, Tim C.
中科院分区：
文献类型：
--
作者：
Schwaiger, Johannes;Markert, Mathias;Lueth, Tim C.
在肝脏手术中，术前计划通常通过使用CT扫描进行。超声探头经常在手术中用于验证组织变形，例如当用超声解剖器切除肝肿瘤时。避免解剖至关重要的肝血管和肿瘤的复发是至关重要的。为了研究实时图像导航在肝脏外科手术中的应用价值，将四个具有真实超声特征的肿瘤模型植入一个装有蜡烛凝胶的碗中。目的是用超声探头定位这些肿瘤，并用超声剥离器安全地穿刺它们。实验共进行了4次，其中1次完全无导航，3次在不同条件下进行超声导航，实时图像导航下穿刺某个肿瘤的尝试次数比无导航时少（P < 0.02%）。基于超声的导航的有效性因手术前提而异。使用合适的导航系统可提高肝脏手术中关键结构（如肿瘤）术中定位的安全性和有效性。然而，切除肝脏肿瘤与适当的安全裕度的要求进一步加强有关的建议方法。
In liver surgery, preoperative planning is usually performed by using CT scans. Ultrasonic probes are frequently used operatively to verify tissue deformations, for example when resecting a liver tumor with an ultrasonic dissector. Avoidance of dissecting vitally important hepatic vessels and the recrudescence of tumors are of crucial importance. The potential benefits of real-time image navigation in operative liver surgery were investigated experimentally.Four model tumors with realistic ultrasonic features have been embedded into a bowl filled with candle gel. The aim was to locate these tumors with the ultrasonic probe and to puncture them safely with the ultrasonic dissector. The experiment was performed four times, once completely without navigation and three times with ultrasonic-based navigation but under different preconditions.Less attempts are needed to puncture a certain tumor with real-time image navigation than without navigation (P < 0.02%). The effectiveness of ultrasonic-based navigation varied with the surgical preconditions.The use of a suitable navigation system improves safety and effectiveness in liver surgery for intraoperative localization of key structures such as tumors. However, resecting hepatic tumors with appropriate safety margin demands for further enhancements concerning the proposed methods.