Laparoscopic Surgery - Tumor resectionIntraoperative 3D imaging for minimally-invasive liver resection

In minimally-invasive liver resection under endoscopy, the surgeon faces the challenge that the preoperative anatomical situation depicted in the MRI or CT images does not match the intraoperative situation and that tactile sensing due to the approach is impaired. The procedure planning that has been done based on these images thus does not precisely visualize the situation at hand any more. The solution to this challenge is intraoperative 3D imaging using syngo Large Volume DynaCT with subsequent image fusion using using syngo iPilot.

partial lobectomy

A 3D acquisition of the liver is thereby taken in the operating room after the CO2 inflation of the abdomen. The preoperative MR images are registered with the intraoperative 3D image and are then overlaid on live fluoroscopy. Through this overlay, the preoperative image is continuously being adapted to the current situation.

An integrated guidance application, syngo iPilot, then helps to navigate the instruments through this up-to-date 3D image and precisely resect the malign part of the organ, which has been marked in the data volume prior to surgery and is now clearly visible under fluoroscopy.

Watch the whole procedure as performed at the German Cancer Research Center, University Hospital Heidelberg

Efficacy of DynaCT for surgical navigation during complex laparoscopic surgery: an initial experience
Nozaki T, Fujiuchi Y, Komiya A, Fuse H.
Surg Endosc. 2013 Mar;27(3):903-9. doi: 10.1007/s00464-012-2531-x. Epub 2012 Oct 6.
PMID:23052511 [PubMed - in process]

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