”The 3D model was essential for assessing tumour involvement of the splenic vessels and, consequently, for planning an associated splenectomy
Dr. Juan Bellido LuqueConsultant General and Digestive Surgeon
Clinical Case
This case involves a 68-year-old male patient presenting with epigastric pain and abdominal distension. Abdominal ultrasound revealed a distended gallbladder with biliary sludge and microlithiasis, thickened and oedematous walls, minimal intrahepatic bile duct dilatation, a 7 mm common bile duct with choledocholithiasis, and a pancreas of normal size and echogenicity. A 2 cm lesion in the pancreatic body was also identified, together with microlithiasis.
Subsequent CT scan and MR cholangiopancreatography (MRCP) demonstrated a 22 mm solid lesion in the pancreatic body with diffusion restriction, not associated with ductal dilatation. In addition, endoscopic ultrasound (EUS) revealed a heterogeneous, hypoechoic lesion with irregular margins in the pancreatic body–tail region, measuring 25.5 × 12.7 mm.
Surgical Planning with the 3D Model
Based on these findings and the suspicion of malignant transformation, laparoscopic distal pancreatectomy was initially proposed.
“The 3D model was essential to assess tumour involvement of the splenic vessels and, therefore, to plan the need for an associated splenectomy,” confirms Dr Juan Bellido, Consultant General and Digestive Surgeon at Hospital Universitario Virgen de la Macarena, Seville.
Tool | Virtual Navigation
The virtual navigation tool integrated within the 3D model provided precise information regarding tumour contact with vascular structures and detailed pancreatic anatomy, optimising intraoperative assessment and enhancing procedural safety.
Surgical Outcome
In the operating theatre, the surgical team successfully performed a laparoscopic distal pancreatectomy with splenectomy, with no intraoperative complications.
The procedure had a total duration of 120 minutes and was led by the Hepatobiliopancreatic Surgery Unit, headed by Dr Ángel Nogales Muñoz. The surgery was performed by members of the unit, led by Dr Juan Bellido Luque, with the collaboration of Dr Inmaculada Sánchez-Matamoros Rodríguez and Dr Cristina Hurtado de Rojas Grau.
Conclusions
The use of 3D reconstructions for surgical planning is becoming increasingly established within the Department of General and Digestive Surgery at Hospital Universitario Virgen de la Macarena, led by Professor Salvador Morales-Conde. This case reflects the department’s ongoing commitment to technological innovation and scientific advancement in surgical practice.
¡Follow us on social media to stay up to date with our latest clinical cases and innovations!
