Abstract
In liver surgery, tumor resection is often the only curative treatment for patients suffering from liver cancer. A detailed planning must precede the actual intervention, because information about liver shape, tumor location, and the arrangement of the vascular structure is required. In addition, quantitative assessment of volumes and distances plays an important role in pre-operative planning.
Currently, in clinical routine, an intervention plan is usually elaborated using the information retrieved from a tomographic imaging modality such as X-ray computed tomography. By inspecting a stack of gray-valued two-dimensional images, a three-dimensional model must be established mentally. While radiologists are trained for this type of analysis, surgeons often have problems, because they are naturally oriented towards 3D due to the nature of their clinical work.
The virtual liver surgery planning framework combines the fields of medical image analysis and computer graphics, in order to simplify the clinical process of planning liver tumor resections. This framework covers important aspects such as robust liver, tumor, and vessel segmentation, interactive segmentation refinement and includes a surgical planning environment.
This thesis focuses on the surgical planning part to help surgeons in elaborating a surgical intervention plan more easily. By using Virtual Reality (VR) techniques, a resection planning environment was developed which allows the simulation of either anatomical or atypical resection strategies using various tools for virtual resections and quantitative measurements. The same techniques applied for Living Donor Liver Transplantation (LDLT). The presented planning tools enable surgeons to partition the liver into tissue target for resection and remaining liver tissue. The partitioning result can therefore deliver an elaborated resection plan individually for each patient.
The researcher applied the Graft Selection Decision Tree for Adult Living Donor Transplantation on two case studies and demonstrated the sensitivity of risk analysis and preoperative planning on Oncologic Resections on one case study. The three case studies were analyzed using Hepavision “MeVis” which is a Virtual Liver surgery planning desktop-based system to highlight the VR techniques used for preoperative surgery planning that give surgeons precise information for optimal surgical decisions.
The researcher interviewed liver transplant surgeons through attending the 6th Egyptian International Conference on Living Donor Liver Transplantation in Dar AlFouad Hospital 1-2 April, 2009. The interviews’ questions are structured to discuss several aspects of surgical planning, in particular Virtual liver surgical planning. The obtained results gained from this assessment were promising. VR-based techniques are useful, because almost each surgical planning task requires 3D interaction (i.e. labeling, specification of partitioning planes/shapes, or navigation). This is also affirmed by surgeons who believe that 3D planning will improve the outcome of surgery and is suitable to be integrated into the clinical workflow.
The researcher designed a structured questionnaire to assess the response of liver surgeons towards the potential use of VR surgical simulators. The questionnaire distributed to 31 liver transplant surgeons at six liver transplant centers in Egypt – Dar AlFouad Hospital, International Medical Center (IMC), El-Maadi Military Hospital, Wady El-Nile Hospital, El-Manial Specialized Hospital and Liver Surgeries Center in Mansoura University. The researcher analyzed the respondents and concluded that simulation can provide an effective means to enhance surgeons feedback on performance, in particular for the practice of resection planning.
The researcher aims to transfer the pre-operative planning process from a traditional desktop-based system to a 3D stereoscopic VR environment where planning gets an easy and intuitive process in the clinical routine.
Currently, in clinical routine, an intervention plan is usually elaborated using the information retrieved from a tomographic imaging modality such as X-ray computed tomography. By inspecting a stack of gray-valued two-dimensional images, a three-dimensional model must be established mentally. While radiologists are trained for this type of analysis, surgeons often have problems, because they are naturally oriented towards 3D due to the nature of their clinical work.
The virtual liver surgery planning framework combines the fields of medical image analysis and computer graphics, in order to simplify the clinical process of planning liver tumor resections. This framework covers important aspects such as robust liver, tumor, and vessel segmentation, interactive segmentation refinement and includes a surgical planning environment.
This thesis focuses on the surgical planning part to help surgeons in elaborating a surgical intervention plan more easily. By using Virtual Reality (VR) techniques, a resection planning environment was developed which allows the simulation of either anatomical or atypical resection strategies using various tools for virtual resections and quantitative measurements. The same techniques applied for Living Donor Liver Transplantation (LDLT). The presented planning tools enable surgeons to partition the liver into tissue target for resection and remaining liver tissue. The partitioning result can therefore deliver an elaborated resection plan individually for each patient.
The researcher applied the Graft Selection Decision Tree for Adult Living Donor Transplantation on two case studies and demonstrated the sensitivity of risk analysis and preoperative planning on Oncologic Resections on one case study. The three case studies were analyzed using Hepavision “MeVis” which is a Virtual Liver surgery planning desktop-based system to highlight the VR techniques used for preoperative surgery planning that give surgeons precise information for optimal surgical decisions.
The researcher interviewed liver transplant surgeons through attending the 6th Egyptian International Conference on Living Donor Liver Transplantation in Dar AlFouad Hospital 1-2 April, 2009. The interviews’ questions are structured to discuss several aspects of surgical planning, in particular Virtual liver surgical planning. The obtained results gained from this assessment were promising. VR-based techniques are useful, because almost each surgical planning task requires 3D interaction (i.e. labeling, specification of partitioning planes/shapes, or navigation). This is also affirmed by surgeons who believe that 3D planning will improve the outcome of surgery and is suitable to be integrated into the clinical workflow.
The researcher designed a structured questionnaire to assess the response of liver surgeons towards the potential use of VR surgical simulators. The questionnaire distributed to 31 liver transplant surgeons at six liver transplant centers in Egypt – Dar AlFouad Hospital, International Medical Center (IMC), El-Maadi Military Hospital, Wady El-Nile Hospital, El-Manial Specialized Hospital and Liver Surgeries Center in Mansoura University. The researcher analyzed the respondents and concluded that simulation can provide an effective means to enhance surgeons feedback on performance, in particular for the practice of resection planning.
The researcher aims to transfer the pre-operative planning process from a traditional desktop-based system to a 3D stereoscopic VR environment where planning gets an easy and intuitive process in the clinical routine.
| Original language | American English |
|---|---|
| Place of Publication | Deutschland / Germany |
| Publisher | LAP lAMBERT academic Publishing |
| Number of pages | 241 |
| ISBN (Electronic) | 9783659356384 |
| ISBN (Print) | 9783659356384 |
| State | Published - 2013 |
Keywords
- Virtual Reality
- Virtual Reality Surgical Planning System (VLSPS)
- Surgical Planning