Liver resection and transplantation using a novel 3D hepatectomy simulation system.

In liver surgery, accurate assessments of liver resection volume and anatomical variation are mandatory for preoperative planning of safe curative hepatectomy. In living donor liver transplantation (LDLT), estimation of hepatic venous drainage is important to avoid liver graft and donor residual liver congestion. This paper reviews the articles on simulation-guided liver surgery and describes our novel 3D hepatectomy simulation system for liver resection and transplantation. Our 3D simulation system, based on the hepatic circulation, provided accurate volumetric and stereotactic information for preoperative planning of curative hepatectomy. In addition, our simulation program was applicable to the hepatic venous system to predict liver congestion in LDLT. Future studies include assessment of the impact of the simulation technologies on surgical education, and their exact cost-effectiveness must be also assessed objectively.