Individualised Liverresection Planning using 3D printing and Virtual Reality

Organizational Data

DRKS-ID:
DRKS00027865
Recruitment Status:
Recruiting ongoing
Date of registration in DRKS:
2022-01-24
Last update in DRKS:
2023-02-21
Registration type:
Prospective

Acronym/abbreviation of the study

i-LiVR

URL of the study

No Entry

Brief summary in lay language

Liver resections, no matter if for benign or malign diseases, are demanding because of the special anatomy of the liver. The liver consists of eight segments of which each has its own blood vessels and bilde ducts. All liver resections have to respect these structures. Furthermore the function of the liver can not be replaced, hence the amount resected is finite. These facts deem the planinng of liver resections as extremely important. Up until now the planning of liver resections was conducted by the surgeon using two dimensional CT scans. The surgeon has to convert these 2D images into a 3D model by the power of his imagination. Several other ways of presenting these data have been developed in the mean time, of which we would like to compare the following: 1. a 3D PDF, which is viewed on a regular computer screen 2. a 3D print, which the surgeon can pick up and view 3. a 3D model of the liver, which is viewed in virtual reality using a VR-headset 4. the goldstandard of the 2D CT scan. The study aims to compare the planned resection volume and the actual resection volume as well as to compare the intra- and postoperative course between the groups.

Brief summary in scientific language

Liver resections are demanding because of the special anatomy of the liver and the high interindividual variability of the afore mentioned. Preoperative planning of liver resections is a key step if successful liver surgery. Up until now this planning step was performed on two dimensional CT scans, the conversion of these data into a three dimensional construct was left to the surgeons power of imagination. A skill that is hard to master and even harder to teach. Several other ways of presenting these data have been developed in the mean time, of which we aim to compare the following: 1. 3D PDF: a 3D reconstruction is viewed on a regular computer screen, the volumetry is performed on this 3d PDF. 2. 3D print: the 3D data set is exported and a 3D print is manufactured. The volumetry is performed using the 3D printed model on a 2D data set on the computer screen. 3. 3D Virtual Reality (VR): the 3D data set is exported into an existing VR application. The volumetry is performed using the VR application. 4. Control: a 2D CT scan is available for planning and volumetry. The study aims to compare the difference between planned and actual resection volume as a primary end point. Secondary end points include intra- and postoperative course as well as usability for the surgical team.

Health condition or problem studied

ICD10:
C78.7 - Secondary malignant neoplasm of liver and intrahepatic bile duct
ICD10:
C22.0 - Liver cell carcinoma
ICD10:
C22.1 - Intrahepatic bile duct carcinoma
ICD10:
D13.4 - Liver
ICD10:
K76.8 - Other specified diseases of liver
ICD10:
B67.0 - Echinococcus granulosus infection of liver
ICD10:
B67.5 - Echinococcus multilocularis infection of liver
Healthy volunteers:
No Entry

Interventions, Observational Groups

Arm 1:
3D PDF: The CT scan is converted into a 3D data set and viewed on a regular computer screen.
Arm 2:
3d print: The CT scan is converted into a 3D data set and a 3D print is manufactured. The surgeon uses this 3D model to prepare for the operation.
Arm 3:
3D VR: the CT scan is converted into a 3D data set and exported for the use with a virtual reality (VR) headset. The surgeon uses this to preapre for the operation.
Arm 4:
Control: a CT scan is viewed on a regular computer screen and is used for preparation for the operation.

Endpoints

Primary outcome:
Quotient of the planned resection volume (RLV1) and the actual resected volume (RLV2), measured by water displacement volumetry, is going to be analyzed ((RLV2 – RLV1)/RLV1).
Secondary outcome:
usability scores, duration of operation, intraoperative blood loss, postoperative hospital stay, postoperativ complications, 30 day mortality, 90 day mortality, sufficient resection margin

Study Design

Purpose:
Treatment
Allocation:
Randomized controlled study
Control:
  • Active control (effective treatment of control group)
Phase:
N/A
Study type:
Interventional
Mechanism of allocation concealment:
No Entry
Blinding:
No
Assignment:
Parallel
Sequence generation:
No Entry
Who is blinded:
No Entry

Recruitment

Recruitment Status:
Recruiting ongoing
Reason if recruiting stopped or withdrawn:
No Entry

Recruitment Locations

Recruitment countries:
  • Germany
Number of study centers:
Monocenter study
Recruitment location(s):
  • Medical center Klinik für Allgemein-, Viszeral- und Transplantationschirurgie der Universitätsmedizin der Johannes Gutenberg-Universität Mainz

Recruitment period and number of participants

Planned study start date:
2022-02-01
Actual study start date:
2022-05-31
Planned study completion date:
No Entry
Actual Study Completion Date:
No Entry
Target Sample Size:
100
Final Sample Size:
No Entry

Inclusion Criteria

Sex:
All
Minimum Age:
18 Years
Maximum Age:
no maximum age
Additional Inclusion Criteria:
elective, primary liver resection laparoscopic and conventional, anatomical and atypical liver resection, major liver resection (>3 segments), age >18, availability of a contrast enhanced ct scan with 3 phases, signed informed consent

Exclusion Criteria

minor liver reseczion, recurrent liver resection, further intraoperative steps planned ahead of time (i.e. simultaneous colon resection, multivsceral resection), cirrhosis of the liver Child B and C

Addresses

Primary Sponsor

Address:
Universiätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie (Ansprechpartner: PD Dr. med. Huber)
Langenbeckstraße 1
55131 Mainz
Germany
Telephone:
No Entry
Fax:
No Entry
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry
Investigator Sponsored/Initiated Trial (IST/IIT):
Yes

Contact for Scientific Queries

Address:
Klinik für Allgemein-, Viszeral und Transplantationschirurgie
PD Dr. med. Tobias Huber
Langenbeckstraße 1
55131 Mainz
Germany
Telephone:
0049 6131 17 2063
Fax:
0049 6131 17 5554
Contact per E-Mail:
Contact per E-Mail
URL:
http://www.unimedizin-mainz.de/avtc

Contact for Public Queries

Address:
Klinik für Allgemein-, Viszeral und Transplantationschirurgie
Yasmin Isenbruck-Wenk
Langenbeckstraße 1
55131 Mainz
Germany
Telephone:
0049 6131 17 2846
Fax:
0049 6131 17 6466
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Principal Investigator

Address:
Klinik für Allgemein-, Viszeral und Transplantationschirurgie
PD Dr. med. Tobias Huber
Langenbeckstraße 1
55131 Mainz
Germany
Telephone:
0049 6131 17 2063
Fax:
0049 6131 17 5554
Contact per E-Mail:
Contact per E-Mail
URL:
http://www.unimedizin-mainz.de/avtc

Sources of Monetary or Material Support

Public funding institutions financed by tax money/Government funding body (German Research Foundation (DFG), Federal Ministry of Education and Research (BMBF), etc.)

Address:
Deutsche Forschungsgemeinschaft
Kennedyallee 40
53175 Bonn
Germany
Telephone:
No Entry
Fax:
No Entry
Contact per E-Mail:
Contact per E-Mail
URL:
http://www.dfg.de

Institutional budget, no external funding (budget of sponsor/PI)

Address:
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Langenbeckstraße 1
55131 Mainz
Germany
Telephone:
0049 6131 17 2063
Fax:
0049 6131 17 5554
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Ethics Committee

Address Ethics Committee

Address:
Ethik-Kommission bei der Landesärztekammer Rheinland-Pfalz
Deutschhausplatz 3
55116 Mainz
Germany
Telephone:
+49-6131-288220
Fax:
+49-6131-2882266
Contact per E-Mail:
Contact per E-Mail
URL:
No Entry

Vote of leading Ethics Committee

Vote of leading Ethics Committee
Date of ethics committee application:
2021-08-01
Ethics committee number:
2021-16021-andere Forschung erstvotierend
Vote of the Ethics Committee:
Approved
Date of the vote:
2021-10-13

Further identification numbers

Other primary registry ID:
No Entry
EudraCT Number:
No Entry
UTN (Universal Trial Number):
No Entry
EUDAMED Number:
No Entry

IPD - Individual Participant Data

Do you plan to make participant-related data (IPD) available to other researchers in an anonymized form?:
No
IPD Sharing Plan:
Not planned up til now.

Study protocol and other study documents

Study protocols:
No Entry
Study abstract:
No Entry
Other study documents:
No Entry
Background literature:
No Entry
Related DRKS studies:
No Entry

Publication of study results

Planned publication:
No Entry
Publikationen/Studienergebnisse:
No Entry
Date of first publication of study results:
No Entry
DRKS entry published for the first time with results:
No Entry

Basic reporting

Basic Reporting / Results tables:
No Entry
Brief summary of results:
No Entry