Recently, Drs. Itaru Endo and Ryuesi, surgeons at Yokohama City University, teamed up with software developer Alexander Kohn from Fraunhofer MEVIS in Germany to develop a new iPad app.
The reason for the app? To minimize complications and risks, while enhancing procedural knowledge during liver surgeries.
At the height of his 25-year surgical career, Endo has a lot of experience operating on the liver. Typically, physicians are resigned to printing images to help them through this type of surgery on one of the most vascularized organs in the body. Surgeons spend time preparing for the procedure by memorizing surgical plans like you’d memorize a complicated map, or utilizing navigation hardware during procedures.
The app is currently undergoing clinical evaluations. The team designed it to provide three-dimensional modeling of organs and complex vascular systems during surgery. According to Dr. Endo, “we use an iPad app to overlay 3D blood vessels and blood flow areas during surgery, giving us more patient information in the operating room.”
Some of the microvasculature that the app can visualize is vitally important for the success of liver operation but invisible to the human eye.
Endo, one of the original developers, hopes that this app can “reduce complications and shorten the length of surgeries,” by minimizing the discrepancy between pre-operative research and what happens in the operating room. What’s more, developers believe that by synthesizing all of the information surgeons need to perform a successful surgery into an interactive tablet application, that the potential reduction in other equipment needed could correspond to savings of millions of dollars.
The same app has been used successfully to remove liver tumors from a patient in Germany. The iPad was utilized to localize the liver tumors. Using a similar technique as mentioned above, the 3D model constructed from films of the patient’s liver. These images were then overlaid over the virtual model and used during the surgery as a sort of real-time map useful in finding the tumors. The app affords surgeons the flexibility to rely less on their memories, reducing the risk of mistake during such a risky procedure.
The technology used in the app improves the quality of transferring pre-operational plans and information into the actual operating room.
“The visualization of liver blood vessels puts surgeons at ease, and it helps to ensure that the right incisions are made at the right time,” Endo said in an interview with Apple.
Tablets are currently being incorporated into other surgical procedures as well. A thoracic group in Japan published their progress in utilizing a mapping system for partial lung removal surgery in 2012, and a British team of plastic surgeons has adopted a similar navigation system. Still others have been successful in incorporating motion sensing technology into their surgical apps3.
About the Author
Dana Carter, PhD is an academically trained, experimental neuroscientist. Currently, Dana is a science writer who focuses on different aspects of psychology, physiology, and overall health and wellness. Prior to her current role, she spent a combined seven years researching the genetic components of mental illnesses, and the effects of drugs and alcohol on fetal brain development. She received her PhD in Neuroscience from the Texas A&M Institute for Neuroscience and her B.Sc. in Psychology from Texas A&M University. She enjoys traveling, writing, and promoting learning about healthy, active minds and lifestyles.
1. Bimmer, F. Inside the iSurgery operation (2013). Reuter’s. http://blogs.reuters.com/photographers-blog/2013/08/20/inside-the-isurgery-operation/
2. New eyes for hands on surgery (2013). Apple. http://www.apple.com/ipad/life-on-ipad/new-eyes-for-hands-on-surgery/
3. Eguchi T, Takasuna K, Kitazawa A, Fukuzawa Y, Sakaue Y, Yoshida K, et al. Three-dimensional imaging navigation during a lung segmentectomy using an iPad. Eur J Cardiothorac Surg. 2012;41(4):893-7.