Performing Intraoperative Computer Assisted Risk Analysis for Oncologic Liver Surgery in Clinical Practice

  • Apollon ZygomalasEmail author
  • Dionissios Karavias
  • Dimitrios Koutsouris
  • Ioannis Maroulis
  • Dimitrios D. Karavias
  • Konstantinos Giokas
  • Vasileios Megalooikonomou
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 57)


Oncologic liver surgery offers the only reasonable chance to cure liver cancer. Selection of patients is essential for effective treatment and in order to minimize perioperative complications. The hepatic surgeon has to achieve complete resection of the tumor(s) including devascularized liver segments and leave a sufficient future liver remnant volume (FLR). Computer assisted risk analysis can provide useful information regarding resectability, anatomical relations, risk areas and volumetric measurements. However, additional findings from the intraoperative ultrasound may modify the resection plan. The aim of this prospective study was to evaluate the intraoperative computer assisted risk analysis for oncologic liver surgery in clinical practice using a novel liver segmentation and surgery planning solution. Fourteen consecutive patients at our institution, undergoing elective major liver resections from August 2014 to July 2015 were enrolled in this prospective study. Additional intraoperative findings were incorporated on-site in the preoperative 3D models of five patients (35%). Mean intraoperative risk analysis time was 4.6min/case SD±0.9. Intraoperative virtual liver resections were designed in less than 2 minutes in all cases (mean 1.4min SD±0.4. The preoperative plan was finally changed in three patients (21%). Intraoperative computer assisted risk analysis provided rapid and reliable reevaluation of the preoperative plan and helped surgeons to select a safe approach for liver oncologic surgery.


Computer assisted surgery Liver segmentation Risk analysis Hepatectomy Oncologic liver surgery 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Apollon Zygomalas
    • 1
    • 2
    Email author
  • Dionissios Karavias
    • 1
  • Dimitrios Koutsouris
    • 3
  • Ioannis Maroulis
    • 1
  • Dimitrios D. Karavias
    • 1
  • Konstantinos Giokas
    • 3
  • Vasileios Megalooikonomou
    • 2
  1. 1.Hepatobiliary and Pancreatic Unit, Department of SurgeryUniversity Hospital of PatrasPatrasGreece
  2. 2.Computer Engineering and Informatics DepartmentUniversity of PatrasPatrasGreece
  3. 3.School of Electrical and Computer EngineeringNational Technical University of AthensAthensGreece

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