Application of 3D Visualization Technology in Perihilar Surgery

The Perihilar area is a complex region where bile ducts, portal veins, hepatic arteries, lymphatics, and nerves intertwine often in an unpredictable way. Anatomical variation is common and the spatial relationships between the vessels are difficult to predict. Imaging techniques greatly assist the surgeon in visualizing the individual anatomy, improving operative precision, patient safety, and shortening duration of surgery. This chapter outlines the characteristic anatomical variation and spatial relationships between the portal veins, hepatic arteries, and bile duct. It categorizes: perihilar diseases and discusses their impact on the hilum, atrophy, and hypertrophy of the liver lobes. We discuss the nature of invasive disease and concomitant difficulties during surgery. We also outline the treatment of disease, and the value of imaging technologies, modeling hepatic lobe segmentation and related vasculature to enable simulated surgery, and for precise preoperative and intraoperative guidance. The chapter closes with a description of the 3D imaging software systems, from image acquisition, and data migration to 3D modelling of the perihilar region and the liver.