While there is a number of individual anatomic variants of hepatic vessels and bile ducts surgeons need to imagine real vessels and ducts position during operation in hepatobiliary zone. In cases of hepatic or pancreatic pathologic process surgeons may meet a limited access to hepatic vessels and bile ducts. Therefore the precision vessels roadmap is highly important for adequate surgical manipulations [1]. Today a lot of CT workstations are equipped with 3D and 4D reconstructing software [2]. But often this software is available for radiologists...

The practice of hepatobiliary and pancreatic surgery planning was analyzed in Sverdlovskaya Oblastnaya Klinicheskaya Bol'nica №1, Regional Hospital #1, Ekaterinburg, Russia. Surgeons who perform surgical interventions on bile ducts and liver vessels wereasked for theirwishes in visual assesment in preoperative planning and intraoperative navigation in a view of actually available opportunities in 3D CT presentation. When analyzing the requirements of surgeons it was revealed that surgeons need to have intraoperative 3D-navigation model and possibilities to control it and fully manipulate it to prevent some issues...

Following software requirements were formulated: 1. Demonstration of liver and pancreatic parenchyma and individual anatomy of vessels, bile ducts position in hepatobiliary zone showed simultaneously without CT workstation in operating room. 2. Possibility to demonstrate the liver, vessels and bile ducts 3D-model during surgical intervention in free rotation. 3. Possibility to change transparency of structures separately and smoothly. 4. Possibility to draw a free line of resection and demonstrate vessels and bile ducts, which will be cut with it. Three major software problems were revealed:...

Despite the fact that today we do not have the software product meting all hepatobiliary surgeons’ requirements, now we have an opinion what this software needs to be like. It`s important to interact closely with 3D reconstruction software developer. Open to cooperation own software developer allows adding of new features rapidly in order to provide the necessary opportunities of intra-operative navigation as well as pre-operative planning.

Soo Jin Kim, Byung Ihn Choi, Se Hyung Kim, Jae Young Lee. Three-dimensional imaging for hepatobiliary and pancreatic diseases: Emphasis on clinical utility. Indian J Radiol Imaging. 2009 Feb; 19(1): 7–15. doi: 10.4103/0971-3026.45336 Uchida M. Recent advances in 3D computed tomography techniques for simulation and navigation in hepatobiliary pancreatic surgery. J Hepatobiliary Pancreat Sci. 2014 Apr;21(4):239-45. doi: 10.1002/jhbp.82