Issue link: https://viewer.e-digitaledition.com/i/100670
Image-Guidance for Liver Surgery Over the past 20 years, image-guided technology has made delicate surgeries, of the head and neck, for example, more precise, and thus, safer and less traumatic for the patient. Recently, the U.S. Food and Drug Administration (FDA) approved an image-guidance system specifically designed for the abdomen. Manufactured by Pathfinder Therapeutics, Inc. (PTI), the Explorer system is the first commercially available system for image-guided surgery of the liver. Last fall, Akron General Medical Center became the first hospital system in Ohio to install it and Dr. Lowe the first to surgeon in Ohio to utilize it for all of his liver resections. ���The liver is a smooth surface, so it���s difficult to see the vasculature and the C ASe Stu dy A 65-YEAR-OLD FEMALE patient presented with metastasis from breast cancer in her liver. One of those metastases was very IMAGES COURTESY OF DR. DAVID ISAACS near a major blood vessel (the right portal From a contrasted CT, these very detailed images of a patient���s liver ��� including the surfaces of the liver and all of the vasculature and the masses ��� were produced by a new image-guidance system to more precisely plan and perform liver surgery. vein) in the liver. A contrasted CT was performed, from which a very detailed 3D image of the patient���s liver anatomy ��� including the surfaces of the liver and all of the vasculature and the masses ��� was produced using the Pathfinder software. From that, the resection plane was planned. With a pre-operative plan in place, the surgeon (Dr. Lowe) was able to track during surgery where he was and where he was going by identifying points on the anatomy with the image in front of him. As a result, he was able to navigate around, with sufficient margin, the metastasis without resecting the right portal vein. And what would have been a 60% resection of the patient���s liver, ended up being a 20% resection. JANUARY- FEBRUARY 2013 ��� MDNEWS.COM ��� MD News Cleveland/Akron/Canton | 25