Tablet app Supports Liver Surgery

A new app designed for tablet computers could support surgeons in the future, helping to reduce the rate of complications during operations.

Developed by researchers at the Fraunhofer Institute for Medical Image Computing (MEVIS; Bremen, Germany), the app helps doctors determine as accurately as possible both before and during an operation where blood vessels inside the organ are located. The app uses established proprietary software for liver operation planning, based on individual three-dimensional (3D) X-ray images, that reconstructs the location of blood vessels in each patient’s liver.

The system was tested for the first time on August 15, 2013, at the Asklepios Klinik Barmbek (Hamburg, Germany), during a liver operation. The surgical team used another feature of the app that is based on a tablets integrated camera, which is used by the surgeons to film the liver during the procedure; the app then superimposed the planning data on the image, showing the branched network vessel system in different colors for identification.

“Using this function, we can virtually look into the organ and make the tumor and vessel structures visible,” said Professor Karl Oldhafer, MD, chief of the department of surgery at the Asklepios Klinik Barmbek. “With this new technology, we are able to better implement computer-supported operation planning for tumor removal. The method has great potential. We imagine using it for operations on other organs, such as the pancreas.”

The app also offers enhanced capabilities. For example, by marking the touchscreen, doctors can measure the length of a vessel to be removed, helping them to estimate whether the remaining ends can be sewn together. And after the surgeon removes certain vessels, he can remove them on the app screen with a virtual eraser, thus virtually viewing the underlying structures. If additional vessels must be removed, the app calculates which parts of the liver will no longer be sufficiently supplied with blood, helping to better estimate if the remaining organ volume is large enough for the patient to survive.

“With our app, the entire set of planning data can be shown directly on the operating table,” said MEVIS computer scientist Alexander Köhn, who developed the first version of the app with doctors at Yokohama City University (Japan). “The app was tested there at the end of 2012 for the first time during an operation. The Japanese surgeons were very impressed by the capabilities of the system. They hope that the app will help reduce complication rates and shorten hospital stays.”

Related Links:
Fraunhofer Institute for Medical Image Computing
Asklepios Klinik Barmbek
Yokohama City University