The three-dimensional visualisation of organs helps us to understand the complex anatomy of the liver. The use of virtual reality for surgical planning and simulation as well as medical training and education will revolutionise the development of liver surgery.

  • Through the three-dimensional reconstruction and analysis of computed tomography (CT) findings, surgeons can stereoscopically and comprehensively observe the location, shape and size of lesions, thus improving their preoperative planning. For intra-operative use as enhanced reality models, external and also internal anatomical deformations due to liver mobilisation need to be simulated. Using a near infrared camera, indocyanin green (ICG) fluorescence could be visualised and quantified intra-operatively to enable an accurate assessment of liver vascularisation, and indirectly of its function. Virtual physiological liver models are being developed, using these anatomical and functional simulations. These virtual physiological models (VPH) of organs are designed to predict the consequences of therapies by creating patient-specific models (digital tweens) to simulate surgical or interventional treatments.
  • Digital tweens for the liver will be improved in order to predict its function and regeneration capability after major hepatectomy or partial liver transplantation. These techniques could also be used as high-fidelity simulators to plan local destruction, liver transplantation or surgery, especially by laparoscopy. VPH could also determine the impact of tumour location on the risk/benefit ratio of different invasive treatments (transplantation, surgery, local destruction, endovascular treatment).
The goals

Development of 3D imaging of the large liver vessels coupled with computational fluid dynamic analysis.

Intraoperative assessment of ICG blood transport by near infra-red imaging of the mesentery and liver during liver surgery and transplantation.

Development of augmented reality to detect anatomical landmarks on both laparoscopic images and preoperative data, and non-rigid feature-based registration.

Development of a mathematical method for the accurate 3D definition of tumour location by considering and revisiting classic anatomical descriptions

Augmented Reality during Open Liver Surgery Using a Markerless Non-rigid Registration System.
Golse N, Petit A, Lewin M, Vibert E, Cotin S.
J Gastrointest Surg. 2021 Mar;25(3):662-671. doi: 10.1007/s11605-020-04519-4. Epub 2020 Feb 10. PMID: 32040812
Comparative analysis of outcomes after liver resection and liver transplantation for early stages hepatocellular carcinoma in HIV-infected patients. An intention-to-treat analysis.
Golse N, Duarte P, Fontana A, Bündchen C, Karam V,Allard MA, Pittau G, Ciacio O, Duclos-Vallée JC, Sa Cunha A, Castaing D, Cherqui D, Adam R, Samuel D, Vibert E.
HPB (Oxford). 2020 Jun;22(6):900-910. doi: 10.1016/j.hpb.2019.10.014. Epub 2019 Nov 14. PMID: 31734238.
Donor HLA Class 1 Evolutionary Divergence Is a Major Predictor of Liver Allograft Rejection : A Retrospective Cohort Study.
Féray C, Taupin JL, Sebagh M, Allain V, Demir Z, Allard MA, Desterke C, Coilly A, Saliba F, Vibert E, Azoulay D, Guettier C, Chatton A, Debray D, Caillat-Zucman S, Samuel D.
Ann Intern Med. 2021 Oct;174(10):1385-1394. doi: 10.7326/M20-7957. Epub 2021 Aug 24. PMID: 34424731.
Impact of COVID - 19 in patients awaiting liver transplantation.
Kounis I, Duhaut L, Breard T, Samuel D, Coilly A.
Liver Int. 2021 Nov 19. doi: 10.1111/liv.15105. Epub ahead of print. PMID: 34797949
Optimizing curative management of hepatocellular carcinoma.
Nahon P, Vibert E, Nault JC, Ganne-Carrié N, Ziol M, Seror O.
Liver Int. 2020 Feb;40 Suppl 1:109-115. doi: 10.1111/liv.14345. PMID: 32077602.
Prognostic impact of surgical margins for hepatocellular carcinoma according to preoperative alpha-fetoprotein level.
Marques F, Ghallab M, Vibert E, Boleslawski E, Soubrane O, Adam R, Farges O, Mabrut JY, Régimbeau JM, Cherqui D, Allard MA, Sa Cunha A, Samuel D, Pruvot FR, Golse N.
HPB (Oxford). 2021 Nov 1:S1365-182X(21)01666-X. doi: 10.1016/j.hpb.2021.10.012. Epub ahead of print. PMID: 34785122.

Augmented Reality during Open Liver Surgery Using a Markerless Non-rigid Registration System.
Nicolas Golse & Antoine Petit & Maïté Lewin & Eric Vibert & Stéphane Cotin.
Journal of Gastrointestinal Surgery
https://doi.org/10.1007/s11605-020-04519-4
Analysis of Liver Resection Versus Liver Transplantation on Outcome of Small Intrahepatic Cholangiocarcinoma and Combined Hepatocellular- Cholangiocarcinoma in the Setting of Cirrhosis.
Eleonora De Martin, Michael Rayar, Nicolas Golse*, Margot Dupeux*, Maximiliano Gelli, Viviane Gnemmi, Marc-Antoine Allard, Daniel Cherqui, Antonio Sa Cunha, René Adam, Audrey Coilly, Teresa Maria Antonini, Catherine Guettier, Didier Samuel, Karim Boudjema, Emmanuel Boleslawski and Eric Vibert.
Liver Transplantation 26 785‒798 2020 AASLD.
Received November 22, 2018; accepted December 26, 2019
Changing Trends in Liver Transplantation: Challenges and Solutions.
Tommy Ivanics, Phillipe Abreu, Eleonora De Martin, Gonzalo Sapisochin.
Transplantation. 2020 Sep 8. doi: 10.1097/TP.0000000000003454. Online ahead of print.PMID: 32910093
Comparative analysis of outcomes after liver resection and liver transplantation for early stages hepatocellular carcinoma in HIV-infected patients. An intention-to-treat analysis.
Golse N, Duarte P, Fontana A, Bündchen C, Karam V, Allard MA, Pittau G, Ciacio O, Duclos-Vallée JC, Sa Cunha A, Castaing D, Cherqui D, Adam R, Samuel D, Vibert E.
HPB (Oxford). 2020 Jun;22(6):900-910. doi: 10.1016/j.hpb.2019.10.014. Epub 2019 Nov 14. PMID: 31734238
Liver transplantation as a rescue therapy for severe neurologic forms of Wilson disease.
Poujois A, Sobesky R, Meissner WG, Brunet AS, Broussolle E, Laurencin C, Lion-François L, Guillaud O, Lachaux A, Maillot F, Belin J, Salamé E, Vanlemmens C, Heyd B, Bellesme C, Habes D, Bureau C, Ory-Magne F, Chaine P, Trocello JM, Cherqui D, Samuel D, de Ledinghen V, Duclos-Vallée JC, Woimant F.
Neurology. 2020 May 26;94(21):e2189-e2202. doi: 10.1212/WNL.0000000000009474. Epub 2020 May 12.
PMID: 32398357
Liver toxicity as a limiting factor to the increasing use of immune checkpoint inhibitors.
Eleonora De Martin, Jean-Marie Michot, Olivier Rosmorduc, Catherine Guettier, Didier Samuel.
PMID: 33205034 PMCID: PMC7648167 DOI: 10.1016/j.jhepr.2020.100170
Optimizing curative management of hepatocellular carcinoma.
Pierre Nahon, Eric Vibert, Jean-Charles Nault, Nathalie Ganne-Carrié, Marianne Ziol, Olivier Seror.
Review Liver Int. 2020 Feb;40 Suppl 1:109-115. doi: 10.1111/liv.14345.PMID: 32077602. DOI: 10.1111/liv.14345
Personalized Preoperative Nomograms Predicting Postoperative Risks after Resection of Perihilar Cholangiocarcinoma.
Nicolas Golse, Julio Nunez, Alessandro Mazzotta, Luis Cano, Damien Bergeat, Laurent Sulpice, Heithem Jeddou, Ahmed Abdelrafee, Antonio Sa Cunha, Daniel Cherqui, René Adam, Karim Boudjema, Eric Vibert.
World J Surg (2020) 44:3449–3460
https://doi.org/10.1007/s00268-020-05618-8
Predictors of unresectability after portal vein embolization for centrally located cholangiocarcinoma.
Ahmed Abdelrafee, MD, Julio Nunez, MD, Luis Cano, PhD, Marc-Antoine Allard, MD, PhD, Gabriella Pittau, MD, Oriana Ciacio, MD, Chady Salloum, MD, Antonio Sa Cunha, MD, Denis Castaing, MD, Daniel Azoulay, MD, PhD, Daniel Cherqui, MD, PhD, René Adam, MD, PhD, Eric Vibert, MD, PhD, Nicolas Golse, MD*
https://doi.org/10.1016/j.surg.2020.03.005
0039-6060/© 2020 Elsevier Inc.
Spleen volumetry and liver transient elastography: Predictors of persistent posthepatectomy decompensation in patients with hepatocellular carcinoma.
Ramiro Fernandez-Placencia, MD, Nicolas Golse, MD, Luis Cano, MD, PhD, Marc-Antoine Allard, MD, PhD, Gabriella Pittau, MD, Oriana Ciacio, MD, Antonio Sa Cunha, MD, Denis Castaing, MD, Chady Salloum, MD, Daniel Azoulay, MD, PhD, Daniel Cherqui, MD, PhD, Didier Samuel, MD, PhD, René Adam, MD, PhD, Eric Vibert, MD, PhD*
https://doi.org/10.1016/j.surg.2020.02.009 0039-6060/© 2020 Elsevier Inc.

Hépatinov develops innovative therapeutic
and diagnostic approaches for hepatic pathologies