Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor, Senior Consultant Arpad Ivanecz, UKC - University Medical Centre Maribor, Slovenia
- Second opponent: Senior consultant Artūras Samuilis, Vilnius University Hospital Santaros Klinikos, Lithuania
- Third member and chair of the evaluation committee: Professor II Heidi Beate Eggesbø, University of Oslo
Chair of the Defence
Professor Emeritus Trond Buanes, University of Oslo
Principal Supervisor
Professor II Bjørn von Gohren Edwin, University of Oslo
Summary
Liver metastases are common in patients with colorectal cancer, one of the most common types of cancer in the World. Surgical removal (resection) is the standard of care and can be performed as an open procedure or minimally invasively - laparoscopically.
The main objective of this doctoral thesis work was to advance further and evaluate methods, techniques, and technologies for minimally invasive liver surgery in current workflows and to explore potential future workflows with enhanced visualization methods outside and inside the operating room.
In the 1st study, perioperative data and long-term outcomes were studied in patients after laparoscopic parenchyma-sparing liver resections (LPSLR) for colorectal metastases. LPSLR is feasible and safe for colorectal liver metastases patients and is associated with satisfactory surgical and long-term oncological outcomes. LPSLR presents surgical outcomes comparable to open surgery alternatives.
In the 2nd and 3rd studies, a mixed reality application was developed to visualize 3D models by processing medical images. Clinical use cases, demonstrations, and questionnaires assessed the application. Mixed reality applications could be integrated into clinical routines with positive feedback and recommendations from clinicians. Viewing patient-specific 3D models in mixed reality has reduced the time needed for a task requiring spatial understanding.
The 4th and 5th studies were preclinical studies simulating laparoscopic liver resection with navigation. Intraoperative imaging significantly improves the accuracy of the laparoscopic navigation system for liver surgery compared to preoperative imaging. A user-induced error has a significant effect on point-to-point registration for laparoscopic navigation. A laparoscopic guidance system for liver resection can be achieved with clinically acceptable accuracy in a hybrid operating room by using fiducials inserted into the liver.