肝脏虚拟手术系统在肝右叶肿瘤手术中的临床应用

Clinical Application of Hepatic Operative Simulation on Liver Resection for Right Lobe Tumor

目的将新研发的肝脏虚拟手术系统(Li Virtue)应用于临床,制订合理的手术方案,降低手术风险,完成精准手术。方法应用Li Virtue系统对32例肝右叶肿瘤患者进行个体化分析,实现对肝脏精确测量、分割,测定各静脉的回流区域;直观显示肝内脉管的分布及变异情况;模拟肝切除的多种手术方式等,选择合理手术方案,并与术中实际情况进行对比。结果肝脏虚拟手术系统可对肝脏体积、区域分割、脉管吻合等情况进行快速准确的个性化分析;可模拟肝脏外科多种手术方式,有助于确定合理手术方案;与32例右肝肿瘤行肝切除术的术中对比,显示该系统虚拟性好,术前模拟结果准确,术中未损伤正常结构,降低了术中风险;所建立的模型也可在便携PC机上展示,方便于术中对照。结论Li Virtue系统有助于揭示个体肝脏的解剖特点,确定合理的手术方式,降低了手术风险,保证了手术安全。

Objective To develop hepatic surgical planning software for hepatic operation on deciding the rational operational scheme and simulating procedures before the operation to accomplish the precise liver resection and decrease the operational risk.Methods 3D-reconstruction of liver was restored from spiral computed tomography（CT） data by using LiVirtue software.The liver and its anatomic structures were reconstructed to illuminate the location of the tumor and its related vessels to design a rational operational scheme.The virtul results,such as liver volume,hepatic sections,anatomy of portal vein and hepatic veins or possible operation plans,were compared with the actual situations during the operations.Results 3D models of liver,tumor and their relative vessels were reconstructed successfully.Preoperative planning and intra-operative navigation based on the models ensured the safety of liver resection in our 32 cases of right lobe tumors.This preoperative simulation allowed surgeons to dissect the liver with reduced complications.These models could be also viewed and manipulated on personal computers.ConclusionThe LiVirtue is very helpful in the hepatic surgery,for clearly disclosing hepatic structures,rationally deciding operation schemes,virtually simulating the operations.This preoperative estimation from 3D model of liver benefits a lot to complicated liver resection.