Real-time Navigation for Liver Surgery Using Projection Mapping With Indocyanine Green Fluorescence

吲哚青绿 医学 解剖(医学) 放射科 回顾性队列研究 肝切除术 外科 切除术
作者
Hiroto Nishino,Etsuro Hatano,Satoru Seo,Takashi Nitta,Tomoyuki Saito,Masaaki Nakamura,Kayo Hattori,Muneo Takatani,Hisakazu Fuji,Kojiro Taura,Shinji Üemoto
出处
期刊:Annals of Surgery [Lippincott Williams & Wilkins]
卷期号:267 (6): 1134-1140 被引量:119
标识
DOI:10.1097/sla.0000000000002172
摘要

Objective: The aim of the present study was to evaluate the usefulness of a new imaging device, the Medical Imaging Projection System (MIPS), which uses the indocyanine green emission signal and active projection mapping, for liver resection. Background: During anatomic liver resection, surgeons cannot completely view the intraparenchymal structure. Although a fluorescent imaging technique using indocyanine green has recently been developed for hepatobiliary surgery, limitations in its application for real-time navigation persist. Methods: We conducted a retrospective review of surgical and clinical outcomes for 23 patients who underwent anatomic hepatectomy using the MIPS and 29 patients who underwent the procedure without MIPS guidance, between September 2014 and September 2015. Results: Preoperative characteristics were comparable between the 2 groups. No significant between-group differences were identified with regard to surgical and clinical outcomes. The demarcation lines were clearly projected by the MIPS in 21 patients; however, the boundary line was undetectable in 2 patients. Conclusions: We developed the MIPS to address limitations in current intraoperative imaging methods. Our retrospective analysis provides evidence of the feasibility and clinical utility of the MIPS to identify anatomical landmarks for parenchymal dissection. The MIPS holds promise as a novel real-time navigation system for liver resection.
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