Evidence map›Paper›PMID 41275463›Full record

ArticleSurgical endoscopy2026

Morphological changes on the human liver during minimally invasive surgery: Implications for image-guided interventions and surgical navigation.

Varatharajan Nainamalai, Håvard Bjørke Jenssen, Luca Boretto, Nikhil Pramod Kumar, Andreas Westenvik Espinoza, Egidijus Pelanis, Bård I Røsok, Ole Jakob Elle, Ingrid Schrøder Hansen, Bjørn Edwin and 1 more

Abstract read
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Varatharajan NainamalaiThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway. nvarat@ous-hf.no.ORCID 0000-0001-9582-8844
Håvard Bjørke JenssenDivision of Radiology and Nuclear Medicine, Oslo University Hospital, 0372, Oslo, Norway.
Luca BorettoThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Nikhil Pramod KumarThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Andreas Westenvik EspinozaThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Egidijus PelanisThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Bård I RøsokDepartment of Hepato-Pancreatic-Biliary Surgery, Oslo University Hospital, 0372, Oslo, Norway.
Ole Jakob ElleThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Ingrid Schrøder HansenThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Bjørn EdwinThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.
Åsmund Avdem FretlandThe Intervention Center, Rikshospitalet, Oslo University Hospital, 0372, Oslo, Norway.

Funding

Helse Sør-Øst RHF 2022-201
6 · The paper itself

Abstract

backgroundMinimally invasive liver resection and ablation depend on surgical planning and image guidance. Surgical planning is normally based on preoperative imaging. The position, shape, and volume of the abdominal organs change during laparoscopy, which challenges image registration and reduces surgical precision. This study aims to analyze the morphological changes of the liver and spleen from pre- to intraoperative (with pneumoperitoneum) computed tomography (CT) images.

methodsWe used portal venous phase pre- and intraoperative CT images from 15 patients who underwent laparoscopic liver ablation in general anesthesia under 12 mmHg pneumoperitoneum at Rikshospitalet, Oslo University Hospital, Oslo, Norway. A rigid registration, based on spinal landmarks, was used to register intraoperative to preoperative CT images. Morphological features were extracted and statistically analyzed for the liver and spleen.

resultsThe liver volume decreased by 12% from the preoperative to the intraoperative CT scan. The mean cranial movement of the liver was 45 mm between pre- and intraoperative CT images. A few morphological radiomic features changed significantly for both liver and spleen.

conclusionTo the best of our knowledge, this is the first published study in humans to analyze the morphological changes of the liver and spleen during pneumoperitoneum. The results show a significant reduction in liver volume and change in shape and position of the liver during such laparoscopy. This deformation from preoperative to intraoperative imaging poses significant challenges for image registration, which is crucial for surgical navigation. These findings highlight the need for updated intraoperative navigation using imaging and registration to ensure accurate surgical planning.

Indexed as

HepatectomyLaparoscopyLiverLiver NeoplasmsSpleenSurgery, Computer-AssistedAdultAgedFemaleHumansMaleMiddle AgedOrgan SizePneumoperitoneum, ArtificialTomography, X-Ray ComputedComputed tomography imagesImage registrationPneumoperitoneumSegmentation

Identifiers

PMID41275463
PMCPMC12881121

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.