Three-dimensional visualization: applications in liver surgery

Three-dimensional (3D) liver visualization is a new tool in liver surgery planning. In most cases, plain or two-dimensional radiological images are hardly perceptible and understandable by the clinician. 3D visualization helps in the perception and interpretation of radiological images. 3D liver visualization are is mostly used before living related liver transplantation and in extended liver resections. In this article, we discuss the usefulness and employment of 3D visualization in clinical practice. Method We observed the whole 3D liver image formation process using OrgaNicer program and present a case report on 3D liver visualization employment in the clinical practice of Vilnius University Santariðkiø Cinics Hospital. Results Benefits of 3D liver visualization: helps in easy perception of difficult liver anatomy and anatomical liver variations; helps to define the surgical plan of liver resection and the extent of operation; precise liver volume calculation increases the safety of the operation. Disadvantages of 3D liver visualization: it is necessary to obtain good quality computer tomography images; long duration (40 to 240 min); a wide range of different specialists and their close cooperation are needed; the lack of defined clinical indications for visualization. Conclusions The new tool for liver surgery planning opens new perspectives in liver surgery, but the difficult course of the process, problems with integration into practice and the lack of clinical indications restrict its use. To increase its employment, indications for three-dimensional liver visualization must be defined and attention must be paid to increasing the quality of small volume liver resection using the new tool