Planning of hepatectomy for tumor resection: Resection surface construction and optimization

Abstract

An interactive liver surgery planning system has been developed to construct and optimize the resection plan. With this system, the segmentation results of the liver and its components (such as tumors and vessels) are comprehensively visualized for surgeons to have an intuitive understanding of the internal anatomical structure of the liver. This system will also allow surgeons to interactively create and modify a resection plan on the virtual liver model. The resection surface, whose boundary is a closed curve, will be automatically constructed with the safe resection margins of tumors. Different from other systems, our developed system is able to generate the safety margins to all tumors. During surgery, a larger resection surface may cause potentially more bleeding and other complications. Therefore, area minimization is applied during the resection surface construction by adopting the minimal area mesh, which is a smooth surface with minimal area. After these virtual modifications, the resultant resection surface indicates the route to cut the liver for tumor removal. The volumes for both resected liver and residual liver are calculated for clinical decision making.