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Living Donor Right Hepatectomy

A right hepatectomy is the surgical removal of the right half of the liver, typically done to remove diseased liver tissue. A living donor right hepatectomy is done to surgically remove half of one person's liver to be used in a life-saving organ transplant. The "donor" procedure being the harvest of a healthy person's liver to be transplanted into a recipient.

The full video with integrated 3D animation and live surgical footage can be viewed at TVASurg.ca A truncated version of the intro animation can be viewed below.

Content Advisors

 

Ian D. McGilvray, MD, FRCSC, PhD
Founding Co-Director TVASurg, HPB & Transplant Editor
Toronto General Hospital, UHN
Division of General Surgery, Department of Surgery,
University of Toronto​

Paul D. Greig, MD, FRCSC, FACS
Founding Co-Director TVASurg, HPB & Transplant Editor
Toronto General Hospital, UHN
Division of General Surgery, Department of Surgery,
University of Toronto​

Narrative

3D animation was used to demonstrate the surgical planning of the case, and highlight key steps in the procedure.

 

Overlay still images were composited with footage to show the suprahepatic cava dissection and relative positions of hepatic veins, and different stages of the porta hepatis dissection and the important structures found there.

Short demo animations were also made to show the hepatic bridge tissue posterior to the vena cava, connecting the caudate and right lobes, and the state of liver transection where a cholangiogram is used to verify bile duct anatomy prior to biliary division.

The following images from the case demonstrate the care taken to drive home certain key narrative concepts in liver transplant surgery: the importance of preoperative planning and the preservation of vascular and biliary structures until the last possible moment, so that the donor liver graft is without blood supply for the least amount of time possible. Often, transplant recipients are prepped in an adjoining operating room.

Process

This project involved modelling, animation, shading, and rendering in Cinema4D, and compositing in Adobe After Effects.

A particular challenge in this case was to emphasize the importance of preoperative imaging for surgical planning, so a boolean cut-away animation was made to show how 2D image scans relate to 3D model reconstructions of the patient's anatomy. At TVASurg, the 3D models we produce are customized to each video, as slight anatomical variations between individuals will often be the focus of surgical planning considerations.

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