• Hiroto Nishino, Etsuro Hatano, Satoru Seo, Takashi Nitta, Tomoyuki Saito, Masaaki Nakamura, Kayo Hattori, Muneo Takatani, Hiroaki Fuji, Kojiro Taura, and Shinji Uemoto.
• Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
• Ann. Surg. 2018 Jun 1; 267 (6): 1134-1140.

ObjectiveThe aim of the present study was to evaluate the usefulness of a new imaging device, the Medical Imaging Projection System (MIPS), which uses the indocyanine green emission signal and active projection mapping, for liver resection.BackgroundDuring anatomic liver resection, surgeons cannot completely view the intraparenchymal structure. Although a fluorescent imaging technique using indocyanine green has recently been developed for hepatobiliary surgery, limitations in its application for real-time navigation persist.MethodsWe conducted a retrospective review of surgical and clinical outcomes for 23 patients who underwent anatomic hepatectomy using the MIPS and 29 patients who underwent the procedure without MIPS guidance, between September 2014 and September 2015.ResultsPreoperative characteristics were comparable between the 2 groups. No significant between-group differences were identified with regard to surgical and clinical outcomes. The demarcation lines were clearly projected by the MIPS in 21 patients; however, the boundary line was undetectable in 2 patients.ConclusionsWe developed the MIPS to address limitations in current intraoperative imaging methods. Our retrospective analysis provides evidence of the feasibility and clinical utility of the MIPS to identify anatomical landmarks for parenchymal dissection. The MIPS holds promise as a novel real-time navigation system for liver resection.

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