Laparoscopic and Robotic Liver Resection Using Advanced 3D Liver Simulation Software = Laparoscopic and Robotic Liver Resection Using Advanced 3D Liver Simulation Software

다국어 초록 (Multilingual Abstract)

Background: Minimally invasive liver resection including laparoscopic and robotic liver resection is a rapidly developing field withthe greatest potential. However, the spatial disorientation is one of the biggest issues that would increase the risk of dangerousbleeding and bile leakage. To overcome this issue, it is of crucial importance to standardize anatomical liver resection with extrahepaticGlissonean pedicle-first approach and to use advanced 3D liver simulation software that can visualize the Glissoneansystem.Methods: We proposed a novel concept of liver anatomy based on Laennec’s capsule that can standardize the extrahepaticGlissonean pedicle approach. Whereas Synapse 3D® is the first simulation software to use face recognition technology for clinical3D simulation and visualization of the Glissonean system are available since version 4.4.Results: Owing to the novel concept of liver anatomy, anatomical liver resection with extrahepatic Glissonean pedicle-first approachwas standardized and target area was well recognized prior to parenchymal dissection with minimal bleeding and bileleakage from the resecting plane. Preoperative 3D simulation and intraoperative navigation contributed to perform systematicanatomical liver resection without spatial disorientation even for the cases with anatomical abnormalities such as right-sidedligamentum teres.Conclusion: Minimally invasive liver resection including laparoscopic and robotic resection became safe and curable procedureswith the novel concept of liver anatomy and advanced 3D liver simulation.