摘要
目的探讨增强现实导航联合吲哚菁绿(ICG)荧光影像技术在腹腔镜解剖性肝脏8段切除中的应用价值。方法回顾性收集2021年10月至2022年10月南方医科大学珠江医院肝胆一科收治的8例肿瘤位于肝脏8段的肝细胞癌患者的临床和病理学资料。男性5例, 女性3例, 年龄40~72岁。术中使用自主研发的腹腔镜增强现实手术导航系统, 将肝脏三维模型与腹腔镜场景进行配准融合, 同时结合ICG荧光影像技术引导解剖性肝脏8段切除。分析患者术前评估预切除肝体积与实际切除体积、相关手术指标和术后并发症发生情况。结果 8例患者中, 4例行腹腔镜解剖性肝脏8段全段切除术, 1例行腹腔镜解剖性肝脏8段腹侧亚段切除术, 2例行腹腔镜解剖性肝脏8段联合腹侧亚段和内侧亚段切除术, 1例行腹腔镜解剖性肝脏8段背侧亚段切除术。手术均在增强现实导航联合ICG荧光影像引导下完成, 无中转开腹情况。手术时间为(276.3±54.8)min(范围:200~360 min);术中出血量为(75.0±35.4)ml(范围:50~150 ml);术中均未输血;术后住院时间为(7.6±0.8)d(范围:7~9 d)。患者围手术期无死亡, 术后未发生出血、胆瘘等并发症。结论增强现实导航联合ICG荧光影像技术能够引导腹腔镜解剖性肝脏8段切除手术的实施。
Objective To investigate the application value of augmented reality navigation combined with indocyanine green(ICG)fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection.Methods Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively.Among them,there were 5 males and 3 females,aged between 40 and 72 years.During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8.The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed.Results Among the 8 patients,4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection,and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection.All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery.The operation time was(276.3±54.8)minutes(range:200 to 360 minutes).Intraoperative blood loss was(75.0±35.4)ml(range:50 to 150 ml).No blood transfusion was performed during the operation.The length of postoperative hospital stay was(7.6±0.8)days(range:7 to 9 days).There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period.Conclusion Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic a
作者
陶海粟
王壮雄
黎柏宏
郭康炜
钱银玲
方驰华
杨剑
Tao Haisu;Wang Zhuangxiong;Li Baihong;Guo Kangwei;Qian Yinling;Fang Chihua;Yang Jian(First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University Guangdong Provincial Clinical and Engineering Center of Digital Medicine,Guangzhou 510282,China;Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences,Shenzhen Key Laboratory of Virtual Reality and Man-machine Interaction,Shenzhen 518055,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2023年第10期880-886,共7页
Chinese Journal of Surgery
基金
国家自然科学基金(82272132)
广东省基础与应用基础研究基金项目(2021A1515011869)
广东省基础与应用基础研究基金粤港澳研究团队项目(2021B1515130003)
中国博士后科学基金(2022M721514)
广州市重点研发计划(2023B03J1246)。
关键词
肝肿瘤
腹腔镜
增强现实导航
吲哚菁绿
解剖性肝脏8段切除
Liver neoplasms
Laparoscopes
Augmented reality navigation
Indocyanine green
Laparoscopic anatomic segment 8 liver resection
