L Roncati1, A Manenti2, E Simonini3. 1. Department of Pathological Anatomy, University of Modena and Reggio Emilia, Modena, Italy. 2. Department of Surgery, University of Modena and Reggio Emilia, Polyclinic Hospital, Via del Pozzo 71, 41124, Modena, Italy. antonio.manenti@unimore.it. 3. Department of Radiology, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
BACKGROUND: The new cross-sectional radiological tools, 3D computed tomography and magnetic resonance, allow a precise study of the liver anatomy. Thanks to these imaging techniques, a new space inside the liver parenchyma, the "hepatic core," was recently recognized, where the hila of liver segments are present. METHODS: On the basis of anatomical and radiological observations, we identified a new virtual plane of dissection, named "hepato-portal," which is useful in liver segmentectomy, if integrated with the classical planes of dissection. RESULTS: Simulated surgical procedures can be intra-operatively transferred by ultrasounds. In this way, we performed ten "proper" liver segmentectomies through preliminary sections of the hilar vessels and a precise dissection of the boundaries of each segment. CONCLUSIONS: Our experience underlines the value of integrating anatomy and radiology in the simulated liver surgery.
BACKGROUND: The new cross-sectional radiological tools, 3D computed tomography and magnetic resonance, allow a precise study of the liver anatomy. Thanks to these imaging techniques, a new space inside the liver parenchyma, the "hepatic core," was recently recognized, where the hila of liver segments are present. METHODS: On the basis of anatomical and radiological observations, we identified a new virtual plane of dissection, named "hepato-portal," which is useful in liver segmentectomy, if integrated with the classical planes of dissection. RESULTS: Simulated surgical procedures can be intra-operatively transferred by ultrasounds. In this way, we performed ten "proper" liver segmentectomies through preliminary sections of the hilar vessels and a precise dissection of the boundaries of each segment. CONCLUSIONS: Our experience underlines the value of integrating anatomy and radiology in the simulated liver surgery.
Authors: David S C Soon; Michael P Chae; Charles H C Pilgrim; Warren Matthew Rozen; Robert T Spychal; David J Hunter-Smith Journal: Ann Med Surg (Lond) Date: 2016-07-12