Application of augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging in laparoscopic hepatectomy
10.3760/cma.j.issn.0529-5815.2019.08.004
- VernacularTitle: 增强现实导航技术联合吲哚菁绿分子荧光影像在三维腹腔镜肝切除术中的应用
- Author:
Chihua FANG
1
,
2
;
Peng ZHANG
1
,
2
;
Huoling LUO
3
;
Wen ZHU
1
,
2
;
Silüe ZENG
1
,
2
;
Haoyu HU
1
,
2
;
Nan XIANG
1
,
2
;
Jian YANG
1
,
2
;
Ning ZENG
1
,
2
;
Yingfang FAN
1
,
2
;
Fucang JIA
3
;
Lianxin LIU
4
Author Information
1. First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University
2. Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou 510282, China
3. Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
4. Department of Hepatobiliary Surgery, the First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Imaging, three-dimensional;
Augmented reality;
Laparoscopic hepatectomy;
Indocyanine green;
Fluorescence
- From:
Chinese Journal of Surgery
2019;57(8):578-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the application value of augmented-reality (AR) surgical navigation technology combined with indocyanine green (ICG) molecular fluorescence imaging in three-dimensional (3D) laparoscopic hepatectomy.
Methods:The clinical data of forty-eight patients who had undergone 3D laparoscopic hepatectomy for hepatocellular carcinoma at First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University from January 2018 to April 2019 were retrospectively analyzed.The patients were divided into two groups: the group of 3D laparoscopic hepatectomy navigated by augment reality technology combined with ICG molecular fluorescence imaging (Group A) , and group of conventional 3D laparoscopic hepatectomy (Group B) . Patients in Group A (n=23) underwent 3D laparoscopic hepatectomy using augmented-reality technology combined with ICG molecular fluorescence imaging. In this group, the self-developed three-dimensional laparoscopic augmented-reality surgical navigation system (No. 2018SR840555) was operated to project the preoperative three-dimensional model to the surgical field, and the use of this system in combination with ICG molecular fluorescence imaging navigated laparoscopic hepatectomy. No surgical navigation technology was applied in Group B (n=25) . All patients signed the informed consent, which were in accordance with the requirements of medical ethics (Ethics No.: 2018-GDYK-003) . The preoperative data, surgical indicators and postoperative complications between the two groups were compared and analyzed.
Results:The median amount of intraoperative blood loss of Group A was 250 (200) ml (M (QR) ) , which was significantly lower than that of Group B (300 (150) ml) (Z=-2.307, P=0.021) .The transfusion rate of Group A was 13.0% (3/23) , which was significantly lower than that of Group B (40.0%, 10/25) (χ2=4.408, P=0.036) .The median postoperative hospitalization time of Group A was 8 (2) d, which was significantly shorter than that of Group B (11 (6.5) d) (Z=-2.694, P=0.007) . There were no serious complications and perioperative death in both groups.The incidence of postoperative complications in Group A was 17.4% (4/23) , which was not significantly different from that in group B (28%, 7/25) (χ2=0.763, P=0.382) .
Conclusion:Augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging has better effect in 3D laparoscopic hepatectomy.
