Synapse 3D represents a great tool for rendering the liver anatomy in a way easily comprehensible even in its most hidden anatomical details. In that it facilitates a better understanding of the findings provided by the pre- and intraoperative imaging tools as computed tomography and moreover intraoperative ultrasound.
Therefore the educational role of Synapse 3D becomes evident and could be fruitful both for students, and physicians who are challenging the liver anatomy for their own perspectives.
Apart from the educational role, which is anyhow relevant, the other perspective in which this tool is representing something clinically crucial in the era of precision medicine, pertains in its capability to disclose in single shot anatomical details, which are not otherwise clearly apparent. In this sense, the detailed 3D reconstruction of the bilio-vascular intrahepatic tree and the possibility to visualize the edges of the areas fed by each single portal branch and drained by each hepatic vein let the surgeons planning precisely the resection area.
Furthermore, having a preoperative idea of the trajectory to be followed while dividing the liver could aid the surgeons while proceeding using the usual resection guidance devices, as it is the ultrasound. Not of lower relevance is the direct consequence of this drawing, represented by the possibility to estimate precisely the volumes of the areas to be removed when the latter are thought according to the tumor location rather than to the usual anatomical landmarks. This possibility provides information otherwise impossible to be obtained in practice.
Then, the preoperative volumetric estimation of portions of the liver non-anatomically defined but comprehensive of the disease to be selectively removed becomes feasible and accurate. In this way a precise estimation of the surgical suitability and risk can be obtained representing a major clinical advancement especially for managing patients carrier of complex oncological involvement of the liver but still amenable of a surgical approach.
GUIDO TORZILLI, MD, PhD, FACS
Professor of Surgery
Humanitas University, School of Medicine
Chairman of the Department of Surgery
Director of the Division of Hepatobiliary & General Surgery
Humanitas Research Hospital, IRCCS