PASSPORT · PAtient Specific Simulation and PreOperative Realistic Training for liver surgery

In 2006, over 45.000 European citizens died of cirrhosis of the liver and 44,000 additional citizens of liver cancer, knowing that the same year 48,700 new liver cancer cases were declared. Surgical procedures remain the options that offer the foremost success rate against such pathologies. Regretfully, surgery is not so frequent due to several limitations. Indeed, eligibility for liver surgery is based on the minimum safety liver volume remaining after resection (standardized FLR), but this minimum value varies over time and from one patient to another according to biological and mechanical properties of the liver. Since 1996, a large set of preoperative planning softwares has been developed, but all of them provide only the volume of the liver before and after resection. However interesting, this limited information is not sufficient to improve the rate of surgical eligibility. PASSPORT for Liver Surgery aims at overcoming these limitations by offering a patient-specific modelling that combines anatomical, mechanical, appearance and biological preoperative modelled information in a unified model of the patient. This first complete Virtual liver" will be developed in an Open Source Framework allowing vertical integration of biomedical data, from macroscopic to microscopic patient information. From these models, a dynamic liver modelling will provide the patient-specific minimum safety standardized FLR in an educative and preoperative planning simulator allowing to predict the feasibility of the gesture and surgeons' ability to realise it. Thus, any patient will be able to know the risk level of a proposed therapy. Finally, we expect to increase the rate of surgical treatment so as to save patients with a liver pathology. To reach these purposes, PASSPORT is composed of a high level partnership between internationally renowned surgical teams, leading European research teams in surgical simulation and an international leading company in surgical instrumentation."