Abstract
Background: Hepatectomy is performed according to the recognition of liver anatomy obtained by preoperative radiological images. Such recognition often differs between operator and assistants. To conquer difference of anatomical recognition, we are going to develop three-dimensional (3D) model navigation for open hepatectomy. Material and methods: Digital segmentation of anatomical structures from multidetector-row computed tomography images utilized the original software “PLUTO”, which was developed by Graduate School of Information Science, Nagoya University. After changing the final segmentation data to the stereolithography files, a 3D printed liver at a 70% scale was produced. The support material was washed and mold charge was removed from 3D printed hepatic veins. The surface of 3D printed model was abraded and coated with urethane resin paint. After natural drying, 3D printed hepatic veins were colored by injection of a dye. The 3D printed portal veins were whitish because mold charge remained. All procedures after 3D printing were performed by hand work. We used 3D print of a liver to hepatectomies for 14 patients. Results: In all study patients, hepatectomy was performed referring to 3D printed model. The planned resections were successful with histologically negative surgical margins. Conclusions: Application of 3D printed liver to hepatectomy is easy and suitable procedure. In the future, diffusion of 3D printing technology in hepatectomy requires further improvement and automatization of hand work after 3D printing.
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