Initial Results of MR-guided Liver Resection in a High-field Open MRI

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2010 Mar 16

PMID 20229210

Citations 3

Authors

Sascha Santosh Chopra

Sven Christian Schmidt

Robert Eisele

Ulf Teichgraber

Ivo van der Voort

Christian Seebauer

Florian Streitparth

Guido Schumacher

Affiliations

Soon will be listed here.

Abstract

Background: The goal of this study was to evaluate high-field open magnetic resonance imaging (MRI) for intraoperative real-time imaging during hand-assisted laparoscopic liver resection. MR guidance has several advantages compared to ultrasound and may represent a future technique for abdominal surgery. Various MRI-safe and -compatible instruments were developed, tested, and applied to realize minimally invasive liver surgery under MR guidance. As proof of the concept, liver resection was performed in a porcine model.

Methods: All procedures were conducted in a 1.0-T open MRI unit. Imaging quality and surgical results were documented during three cadaveric and two live animal procedures. A nonferromagnetic hand port was used for manual access and the liver tissue was dissected using a Nd:YAG laser.

Results: The intervention time ranged from 126 to 145 min, with a dissection time from 11 to 15 min. Both live animals survived the intervention with a blood loss of 250 and 170 ml and a specimen weight of 138 and 177 g. A dynamic T2W fast spin-echo sequence allowed real-time imaging (1.5 s/image) with good delineation of major and small hepatic vessels. The newly developed MR-compatible instruments and camera system caused only minor interferences and artifacts of the MR image.

Conclusion: MR-guided liver resection is feasible and provides additional image information to the surgeon. We conclude that MR-guided laparoscopic liver resection improves the anatomical orientation and may increase the safety of future minimally invasive liver surgery.

Citing Articles

Identification of liver metastases with probe-based confocal laser endomicroscopy at two excitation wavelengths.

Schneider C, Johnson S, Gurusamy K, Cook R, Desjardins A, Hawkes D Lasers Surg Med. 2016; 49(3):280-292.

PMID: 27990658 PMC: 5396307. DOI: 10.1002/lsm.22617.

[Intraoperative multidimensional visualization].

Sperling J, Kauffels A, Grade M, Alves F, Kuhn P, Ghadimi B Chirurg. 2016; 87(12):1015-1024.

PMID: 27796416 DOI: 10.1007/s00104-016-0314-y.

Laparoscopic liver resections for hepatocellular carcinoma: current role and limitations.

Gaillard M, Tranchart H, Dagher I World J Gastroenterol. 2014; 20(17):4892-9.

PMID: 24803800 PMC: 4009520. DOI: 10.3748/wjg.v20.i17.4892.

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