Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 9, Issue 5, pp 592–599

Navigation and image-guided HBP surgery: a review and preview

  • Wolfram Lamadé
  • M. Vetter
  • P. Hassenpflug
  • Matthias Thorn
  • Hans-Peter Meinzer
  • Christian Herfarth
Surgeon at work

DOI: 10.1007/s005340200079

Cite this article as:
Lamadé, W., Vetter, M., Hassenpflug, P. et al. J Hep Bil Pancr Surg (2002) 9: 592. doi:10.1007/s005340200079

Abstract.

Image-guided surgery and navigation have resulted from convergent developments in radiology, teletransmission, and computer science. Patient selection and preoperative planning in hepatobiliary-pancreatic (HBP) surgery rely on preoperative imaging. The operative procedure is finally led by the fusion of additional information gained by the palpating hand and intraoperative ultrasound. Despite advances in reducing morbidity and mortality, decisions are often hardly quantifiable and are restricted to super-specialists in HBP surgery. New developments in computed tomography (CT) and magnetic resonance imaging (MRI) technology have led to the possibility of the volumetric prediction of liver resections. These data can be shared via telemedicine and used for simulation and training. Three-dimensional (3D) reconstructions have led to a better topologic understanding of tumor-vascular tree relations in the individual patient. With the increasing use of ablative procedures and laparoscopy, intraoperative imaging and navigation will hold increasing significance for the HBP surgeon. Flat screen monitors adjacent to the surgical field present computer-generated 3D virtual liver resection proposals which can be transferred into the real liver. The main obstacles in HBP navigation are the flexibility and mobility of the target organ. Intrahepatic and surface markers seem to be mandatory for computer-navigated surgery. The first feasibility studies are promising.

Key words Navigation Image-guided Surgery Liver HBP Virtual Telemedicine 

Copyright information

© Springer-Verlag Tokyo 2002

Authors and Affiliations

  • Wolfram Lamadé
    • 1
  • M. Vetter
    • 2
  • P. Hassenpflug
    • 2
  • Matthias Thorn
    • 2
  • Hans-Peter Meinzer
    • 2
  • Christian Herfarth
    • 1
  1. 1. Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 210, 69120 Heidelberg, GermanyDE
  2. 2. Division of Medical and Biological Informatics, German Cancer Research Center, Heidelberg, GermanyDE