Intraoperative image-guided laparoscopic and robotic hepatectomies

Abstract

Laparoscopic and robotic hepatectomies have proved to be safe and feasible with advantages of minimally invasive and enhanced recovery, despite the inherent defects of restricted endoscopic angle of vision and having no tactile sensing. In recent years, the development of intraoperative image-guided techniques, such as real-time intraoperative ultrasonography, intraoperative CT/MRI-guided navigation system, fusion ICG fluorescence imaging, and augmented reality, have greatly assisted surgeons with precise targeting of the tumors, preoperative surgical planning, along with supervision and in-time revision of the amputation plane of hepatic papernchyma. Therefore, it has enabled precise hepatectomy without damaging important vascular structures, reduced intraoperative blood loss, and increased the safety of surgical procedures. Besides, intraoperative image guide could compensate the defect of restricted vision in laparoscopic and robotic hepatectomies, pushing the limits of human vision field. This article will describes the application of image-guided techniques in laparoscopic and robotic hepatectomies. Key words: Image-guided surgery; Laparoscopic surgery; Robotic surgery; Hepatectomy