[POTENTIAL FOR THREE-DIMENSIONAL ANALYSIS UTILIZATION IN PANCREATECTOMY].

Abstract

Preoperative simulation and intraoperative navigation using three-dimensional (3D) analysis has been established and is indispensable in liver surgery. However, 3D analysis has not been developed in pancreatic surgery. Recently, we have been able to perform 3D analysis of the pancreas and make 3D models of it with surrounding vascular structures and tumors using a 3D printer. Preoperative computed tomography (CT) images were reconstructed in a 3D configuration, including the pancreatic parenchyma, tumors, pancreatic duct, bile duct, portal venous system, and hepatic and superior mesenteric arteries. Pancreas models with internal structures in color were made of soft resin with a 3D printer. The 3D printed models were made in cases when patients were to undergo laparoscopic distal pancreatectomy and pancreatoduodenectomy with anomalies of the hepatic arteries, i.e., the replaced right hepatic artery. Preoperatively, the surgeons simulated surgical plans using the 3D model and acquired real images of surgical procedures. Intraoperatively, the surgeons performed pancreatic resection with navigation using the 3D pancreas model in a sterilization bag. Simulation and navigation using 3D analysis and 3D printed pancreas models can be useful in pancreatic surgery, in cases of laparoscopic surgery, and in patients with vascular anomalies.