SG Leaders: Alfred Kow Wei Chieh (Singapore)
Deniz Balci (Turkey)
Background/rationale
3D modelling of liver anatomy is now commonly available. It allow surgeons to be able to visualise the anatomy of the liver (often complex, due to the intricate arterial, venous and biliary structures in the liver). When implemented in liver resection for oncology cases eg HCC or colorectal liver metastasis and also in liver donor operation for LDLT, this is likely to enhance the accuracy of the surgical planning and performig of the liver resection. It also has great value in education and trainig of young liver surgeons who are learning to perform the procedure.
In addition to pre-operative simulation, selected devices such as Hololens and/ or Apple Vision Pro have now been used as the enabling devices to house these 3D images and create holographic (mixed reality) models which can be used as real tim reference and navigation of liver resection, in both open and minimally invasive manner.
In this study, we would like to evaluate the efficacy of this technology in pre-operative simulation and/ or intraoperative navigation of liver resection.
Objectives
To evaluate the collective experience of HPB surgeons who use 3D reconstructed models for surgical planning, simulation and navigation in the World.
Peri-hilar cholangiocarcinoma is a malignant disease that originates from the epithelium of the peri-hilar bile ducts. Given the peculiar anatomical location and the need to perform the patient and for the hepato-biliary surgeons. Surgery is the treatment of choice for most patients and involves major hepatectomy associated with biliary tract resection and locoregional lymphadenectomy. In addition, to achieve radical intervention, vascular resections (portal vein and/or hepatic artery) or pancreatico-duodenectomy may be necessary. Such extensive resection required a specific preoperative management in order to improve the safety and reduce the rates of postoperative morbidity that remains high also in referral centers.
