Liver surgery navigation by shape estimation of flexible organs and real-time registration to preoperative models

2021 Fiscal Year Final Research Report

• Project/Area Number: 18H03546
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 90130:Medical systems-related
• Research Institution: Tokyo Medical University
• Principal Investigator: Oshiro Yukio 東京医科大学, 医学部, 講師 (10535008)
• Co-Investigator(Kenkyū-buntansha): 北原 格 筑波大学, 計算科学研究センター, 教授 (70323277)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 肝切除術 / 手術シミュレーション / 手術ナビゲーション

Outline of Final Research Achievements

We investigated the development and accuracy of a liver surgery navigation education tool that estimates the shape of flexible organs in hepatobiliary and pancreatic surgery and registrates them with a preoperative model in real time. Using two stereovision 3D cameras composed of optical sensors, the organ shape, position, cut surface, and cut line were captured and analyzed, and the registration was performed on the simulation screen. The coordinates of the cut line data extracted in the surgical field were sent to the simulation software, and the position of the cut line was reflected at the corresponding position on the liver CG model. In the left lateral segmentectomy with no hepatic mobilization and shallow cut line, the timing of appearance of the Glisson was almost the same, and the surgical navigation was effective.

Free Research Field

肝胆膵外科

Academic Significance and Societal Importance of the Research Achievements

3D手術シミュレーションはワークステーションの発展を背景に肝臓手術で保険収載となって以降必要不可欠となった。肝臓の内部は、門脈、胆管、肝静脈などの脈管が複雑に交錯しており脈管走行を把握しなければ、脈管損傷による大量出血につながり生命の危険性が高まる。手術合併症を減らすためには、シミュレーションによる事前準備に加えて、手術手順や脈管などの不可視部位をリアルタイムで可視化、提示するナビゲーション支援の出現が待たれている。手術の進行に応じて形状が変化した3D-CGモデルを観察できれば、切離位置と切離プロセスを容易に把握可能であり、次の切離の予見が可能なナビゲーションとなり手術の安全性向上につながる。