1. The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310006, China
2. Health Science Center, Ningbo University, Ningbo 315211, China
| Abstract: | Three-dimensional (3D) reconstruction technology, as a vital component of digital medicine, has emerged as a powerful tool in the field of hepatic surgery, particularly in the context of precision liver resection. This review examines the current applications and future prospects of 3D reconstruction technology in hepatic surgery, with a focus on its clinical progress in preoperative assessment, vascular protection, surgical planning, and intraoperative navigation. By accurately calculating liver volume, evaluating liver function reserves, and optimizing surgical strategies, 3D reconstruction significantly enhances the safety and efficacy of liver resection. In terms of vascular protection, 3D reconstruction enables precise localization of tumors relative to vascular structures and identification of vascular variations, thereby reducing intraoperative bleeding risks. For surgical planning, the integration of 3D reconstruction with virtual reality (VR) and augmented reality (AR) technologies allows for the creation of virtual surgical scenarios, optimization of surgical pathways, and reduction of operative time. In intraoperative navigation, 3D reconstruction combined with laparoscopic ultrasound, indocyanine green (ICG) fluorescence imaging, 3D printing, and mixed reality (MR) technologies has enabled real-time navigation, thereby improving surgical precision. Despite these advancements, 3D reconstruction technology still faces challenges, including high costs, time-consuming processes, data quality limitations, and suboptimal reconstruction of intrahepatic bile ducts. Looking ahead, the incorporation of artificial intelligence and big data into 3D reconstruction is expected to further refine preoperative planning and intraoperative navigation, driving the field of hepatic surgery toward greater intelligence and precision. |
| Keywords: | Liver Surgery; Three-dimensional Reconstruction Techniques; Precision Liver Resection; Preoperative Planning; Intraoperative Navigation; Personalized Treatment |
| DOI: | 10.57237/j.cmf.2025.01.002 |
| 1. | TCM Science and Technology Plan Project of Zhejiang Province (No. 2022ZB323) |
| 2. | The Medical and Health Science and Technology Plan Project of Zhejiang Province (No. 2022KY1114) |
| 3. | The Medical Science and Technology Project of Zhejiang Province (No. 2024KY1499) |
| [1] | Hepatic Surgery Group of the Chinese Medical Association Surgical Branch. Liver anatomy and hepatic resection: Nomenclature of surgery and principles for controlling bleeding during hepatectomy [J]. Abdominal Surgery, 2017, 30(2): 75-78. https://doi.org/10.3969/j.issn.1003-5591.2017.02.002 |
| [2] | Zhou XJ, Qin L, Qian HX, et al. Impact of virtual liver surgery on hepatic surgical protocols and intraoperative strategies [J]. Chinese Journal of Hepatobiliary Surgery, 2013, 19(2): 93-97. https://doi.org/10.3760/cma.j.issn.1007-8118.2013.02.003 |
| [3] | Hashimoto D, Dohi T, Tsuzuki M, et al. Development of a computer-aided surgery system: three -dimensional graphic reconstruction for treatment of liver cancer [J]. Surgery, 1991, 109(5): 589-596. |
| [4] | Wu WM. Analysis of risk factors for acute liver failure after partial hepatectomy in patients with cirrhosis and hepatocellular carcinoma [J]. Journal of Hepatobiliary Surgery, 2020, 28(1): 60-64. https://doi.org/10.3969/j.ISSN.1006-4761.2020.01.017 |
| [5] | Pei JP, Ding YM. Methods of assessing liver reserve function before hepatectomy [J]. Journal of Clinical Hepatobiliary Disease, 2023, 39(05): 1219-1226. |
| [6] | Gong WF, Lu Z, Zhang ZY. A clinical study of standardized residual liver volume for predicting liver failure after hemihepatectomy in patients with hepatocellular carcinoma combined with cirrhosis. China Tumor Clinic, 2018, 45(5): 232-236. https://doi.org/10.3969/j.issn.1000-8179.2018.05.500 |
| [7] | Heymsfield SB, Fulenwider T, Nordlinger B, et al. Accurate measurement of liver, kidney, and spleen volume and mass by computerized axial tomography [J]. Ann Intern Med, 1979, 90(2): 185-187. |
| [8] | Shen YH, Sun HC, Zhou J. Assessment of liver reserve function before hepatectomy [J]. Chinese Electronic Journal of Liver Surgery, 2019, 8(6): 469-472. |
| [9] | Liu Y, Wang Q, Du B, Wang X, Xue Q, Gao W. A meta-analysis of the three-dimensional reconstruction visualization technology for hepatectomy. Asian J Surg. 2023; 46(2): 669-676. https://doi.org/10.1016/j.asjsur.2022.07.006 |
| [10] | Zeng X, Tao H, Dong Y, et al. Impact of three-dimensional reconstruction visualization technology on short-term and long-term outcomes after hepatectomy in patients with hepatocellular carcinoma: a propensity-score-matched and inverse probability of treatment-weighted multicentre study. Int J Surg. 2024; 110(3): 1663-1676. Published 2024 Mar 1. https://doi.org/10.1097/JS9.0000000000001047 |
| [11] | Y. Z. Individualized three-dimensional reconstruction of hepatic vein and portal vein in liver surgery [D]. Southern Medical University, 2013. |
| [12] | Li PP, Wang ZH, Huang G, et al. Study on the application of liver three-dimensional visualization technology in the treatment planning of liver malignant tumors [J]. Chinese Surgery Misc, 2017, 55(12): 916-922. |
| [13] | Oshiro Y, Ohkohchi N. Three-dimensional liver surgery simulation: computer-assisted surgical planning with threedimensional simulation software and three-dimensional printing. Tissue Eng Part A, 2017, 23(11-12): 474-480. |
| [14] | Sampogna G, Pugliese R, Elli M, Vanzulli A, Forgione A. Routine clinical application of virtual reality in abdominal surgery. Minim Invasive Ther Allied Technol. 2017; 26(3): 135-143. https://doi.org/10.1080/13645706.2016.1275016 |
| [15] | Wang DP, He RP, Jia ZP, et al. Laparoscopic ultrasound combined with CT three-dimensional reconstruction to guide laparoscopic hepatectomy [J]. China Medical Imaging Technology, 2024, 40(02): 172-176. https://doi.org/10.13929/j.issn.1003-3289.2024.02.003 |
| [16] | Lou LP, Zhang LQ, Liu HC. Application effect of ultrasonography combined with mixed reality technology in laparoscopic anatomic hepatectomy [J]. PLA Medical Journal, 2023, 48(10): 1208-1213. |
| [17] | Liu JQ, Chen WJ, Yin Q, et al. Application of digital three-dimensional reconstruction technology combined with intraoperative ultrasound navigation in anatomic hepatectomy in children [J]. Journal of Clinical Pediatric Surgery, 2021, 20(10): 930-934. |
| [18] | Ishizawa T, Saiura A, Kokudo N. Clinical application of 4 indocyanine green-fluorescence imaging during hepatectomy. Hepatobiliary Surg Nutr, 2016, 5(4): 322-328. |
| [19] | Liu YJ, Wu H, Zheng Y, et al. Luminal ultrasound combined with fluorescence imaging in laparoscopic hepatectomy [J]. Chinese Basic and Clinical Journal of General Surgery. 2020, 27(06): 662-665. |
| [20] | Terasawa M, Ishizawa T, Mise Y, et al. Applications of fusionfluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg Endosc, 2017, 31(12): 5111-5118. |
| [21] | Du B, Wang ZX, Wu H. Application of ICG fluorescence staining in laparoscopic surgery of HCC with cirrhosis [J]. J Univ South China (Med Ed), 2021, 49(5): 555-558. |
| [22] | Zein NN, Hanouneh IA, Bishop PD, et al. Three-dimensional print of a liver for preoperative planning in living donor liver transplantation. Liver Transpl. 2013; 19(12): 1304-1310. https://doi.org/10.1002/lt.23729. |
| [23] | Igami T, Nakamura Y, Oda M, et al. Application of three-dimensional print in minor hepatectomy following liver partition between anterior and posterior sectors. ANZ J Surg. 2018; 88(9): 882-885. https://doi.org/10.1111/ans.14331 |
| [24] | Huber T, Huettl F, Tripke V, Baumgart J, Lang H. Experiences With Three-dimensional Printing in Complex Liver Surgery. Ann Surg. 2021; 273(1): e26-e27. https://doi.org/10.1097/SLA.0000000000004348 |
| [25] | Wang S, Zhang Y, Wang T. Augmented reality technology and its application in surgery [J]. China Medical Devices, Inc. 2021, 36(7): 161-165. |
| [26] | Ma L, Zhao Z, Zhang B, et al. Three-dimensional augmented reality surgical navigation with hybrid optical and electromagnetic tracking for distal intramedullary nail interlocking. Int J Med Robot. 2018; 14(4): e1909. https://doi.org/10.1002/rcs.1909 |
| [27] | Tang R, Ma LF, Rong ZX, et al. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods. Hepatobiliary Pancreat Dis Int. 2018; 17(2): 101-112. https://doi.org/10.1016/j.hbpd.2018.02.002 |
| [28] | Hallet J, Gayet B, Tsung A, et al. Systematic review of the use of pre-operative simulation and navigation for hepatectomy: current status and future perspectives. J Hepatobiliary Pancreat Sci, 2015, 22(5): 353-362. |
| [29] | Kingham TP, Jayaraman S, Clements LW, et al. Evolution of image-guided liver surgery: transition from open to laparoscopic procedures. J Gastrointest Surg, 2013, 17(7): 1274-1282. |
| [30] | Teatini A, Pelanis E, Aghayan DL, et al. The effect of intraoperative imaging on surgical navigation for laparoscopic liver resection surgery. Sci Rep. 2019; 9(1): 18687. Published 2019 Dec 10. https://doi.org/10.1038/s41598-019-54915-3 |
| [31] | Pelanis E, Teatini A, Eigl B, et al. Evaluation of a novel navigation platform for laparoscopic liver surgery with organ deformation compensation using injected fiducials. Med Image Anal. 2021; 69: 101946. https://doi.org/10.1016/j.media.2020.101946 |
| [32] | HALLET J, GAYET B, TSUNG A, et al. Systematic review of the use of pre-operative simulation and navigation for hepatectomy: current status and future perspectives [J]. J Hepatobiliary Pancreat Sci, 2015, 22(5): 353-362. |
| [33] | Bertrand LR, Abdallah M, Espinel Y, et al. A case series study of augmented reality in laparoscopic liver resection with a deformable preoperative model. Surg Endosc. 2020; 34(12): 5642-5648. https://doi.org/10.1007/s00464-020-07815-x |
| [34] | Kong, SH., Haouchine, N., Soares, R. et al. Robust augmented reality registration method for localization of solid organs’ tumors using CT-derived virtual biomechanical model and fluorescent fiducials. Surg Endosc 31, 2863–2871 (2017). https://doi.org/10.1007/s00464-016-5297-8 |
| [35] | Tang R, Ma L, Xiang C, et al. Augmented reality navigation in open surgery for hilar cholangiocarcinoma resection with hemihepatectomy using video-based in situ three-dimensional anatomical modeling: A case report. Medicine (Baltimore). 2017; 96(37): e8083. https://doi.org/10.1097/MD.0000000000008083 |
We invite active, qualified and high profile scientists and researchers to join as Editorial Board Members.
Join UsScholars with a strong interest in reviewing are invited to join the reviewer panel to ensure the quality of the research to be published.
Join Us