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DOI: 10.1055/s-2007-981248
© Georg Thieme Verlag Stuttgart · New York
Navigation und Visualisierung in der Leberchirurgie - Aktueller Stand
Navigation and Visualisation in Liver Surgery - Current SituationPublication History
Publication Date:
23 August 2007 (online)
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Zusammenfassung
Seit weniger als zehn Jahren werden im Rahmen internationaler Projekte durch einige wenige Arbeitsgruppen verstärkte Anstrengungen unternommen, auch für die Leberchirurgie die Anwendung von Navigationstechniken zu ermöglichen. Bisher war die Anwendung von navigierten Instrumenten nur in chirurgischen Fächern möglich, welche sich mit der Therapie an starren anatomischen Strukturen (Knochen) oder an mit Knochen umgebenen Weichteilen (Gehirn) beschäftigten. Es gelang zunächst für die präoperative Planung verschiedene Software-Systeme zu entwickeln, welche zu einer besseren Evaluation und Patientenauswahl beitragen. Mehrere alternative Ansätze zur Transformation der Planungsergebnisse befinden sich derzeit in der Erprobungsphase. Für die konventionelle Leberresektion konnte ein Navigationstool bereits erfolgreich angewendet werden. Im Rahmen des FUSION-Projektes[1] ist nun auch erstmals ein Prototyp für das intraoperative Tracking laparoskopischer Instrumente entwickelt und erprobt worden. Zukünftige Entwicklungen auf dem Gebiet der Navigationsstechnologie lassen zum einen signifikante Fortschritte in der Therapie chirurgisch relevanter Lebererkrankungen und zu anderen auch erhebliche Synergieeffekte bezüglich gesundheitsökonomischer Konsequenzen erwarten.
Abstract
Since less than ten years increasing efforts are undertaken within the framework of international projects through of a few teams, to facilitate the application of navigation techniques also for the liver surgery. Up to now the application of navigated instruments was possible only in surgical compartments that dealt with the therapy at inflexible anatomical structures (bone) or at soft parts surrounded with bones (brain). Succeeded first of all for the prefunctional planning in developing different software-systems that contribute to a better evaluation and patient selection. There are currently in the testing phase several alternative approaches for the transformation of the planning results. For the conventional liver resection a navigation tool could be used already successfully. Within the framework of the FUSION-project a prototype is now also for the first time developed and tested for the intraoperative tracking of laparoscopic instruments. Future developments on the field of the navigation technology let on the one hand significant progress in the therapy surgical relevant liver illnesses' and to expect also considerable synergy effects to other concerning health-economic consequences.
Schlüsselwörter
Leberchirurgie - Navigation - Visualisierung
Key words
Liver surgery - Navigation - Visualisation
1 FUSION (Future Environment for gentle Liver Surgery using Image-guided Planning and Intra-operative Navigation), BMBF Fördernummer 01 EQ 0401.
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1 FUSION (Future Environment for gentle Liver Surgery using Image-guided Planning and Intra-operative Navigation), BMBF Fördernummer 01 EQ 0401.
Dr. med. L. Mirow
Universitätsklinikum Schleswig-Holstein · Campus Lübeck · Klinik für Chirurgie
Ratzeburger Allee 160
23538 Lübeck
Email: lutz.mirow@uk-sh.de