Hemihepatectomy is a regular way to resect the liver graft for living donor liver transplantation. Middle hepatic vein (MHV)-guided precise hemihepatectomy demands high-quality pre-surgery planning. This paper presents a pre-operative planning system to assist surgeons in risk assessment and planning the resection pathway with a desired safety margin to MHV. Our algorithm is able to automatically construct a smooth resection pathway according to a few user-input control points and the desired safety margin. Moreover, the resection pathway is optimized by minimizing the resection area for less liver impair. Experiment of planning MHV-guided hemihepatectomy on six healthy livers was conducted and the blood-free liver parenchyma volumes of the graft and the remnant were computed for risk assessment. The comparison between the planning results using the proposed system and the results from the conventional 2D slice-based planning suggests that the proposed planning system is more convenient and provides a better planning result.
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This work is partially supported by a research grant (JCOAG03-FG05 2009) from A∗STAR of Singapore.