Liver of the ‘‘Visible Man’’ J.H.D. FASEL, 1 * P. GINGINS, 2 P. KALRA, 2 N. MAGNENAT-THALMANN, 2 C. BAUR, 3 J.F. CUTTAT, 4 M. MUSTER, 5 AND P. GAILLOUD 5 1 Department of Morphology, University Medical Center, Geneva, Switzerland 2 MIRALab, University Center for Informatics, Geneva, Switzerland 3 Swiss Federal Institute of Technology, Lausanne, Switzerland 4 Department of DigestiveSurgery, University Hospital, Lausanne, Switzerland 5 Department of Radiology, University Hospital, Geneva, Switzerland Endoscopic surgery, also called minimally invasive surgery, is presumed drastically to reduce postoperative morbidity and thus to offer both human and economic benefits. For the surgeon, however, this approach leads to a number of gestural challenges that require extensive training to be mastered. In order to replace experimentation on animals and patients, we developed a simulator for endoscopic surgery. To achieve this goal, a first step was to develop a working prototype, a ‘‘standard patient,’’on which the informatic and microengineering tools could be validated. We used the visible man dataset for this purpose. The external shape of the visible man’s liver, his biliary passages, and his extrahepatic portal system turned out to be fully within the standard pattern of normal anatomy. Anatomic variations were observed in the intra- hepatic right portal vein, the hepatic veins, and the arterial blood supply to the liver. Thus, the visible man dataset reveals itself to be well suited for the simulation of minimally in- vasive surgical operation such as endoscopic cholecystectomy. Clin. Anat. 10:389–393, 1997.  1997 Wiley-Liss, Inc. Keywords:virtual surgery; endoscopic cholecystectomy; clinical anatomy; vis- ible human project INTRODUCTION Derived from gynecological laparoscopy, endo- scopic surgery (also called minimally invasive surgery or coelioscopy) has imposed itself since the end of the 1980s as a new method, first in abdominal, then in thoracic surgery (McKernan, 1994). It is presumed drastically to reduce postoperative morbidity and thus to offer both human and economic benefits. For the surgeon, however, this approach involves a number of gestural challenges, such as manipulation of new kinds and sizes of instruments, adaptation to a restricted field of view, bimanual ability with inversed eye-hand coordination, and loss of tactile feedback. T hus, exten- sive training is required that must avoid endangering living patients or risk ethical or political limitations in regard to animal experiments (Imbembo and Zucker, 1991; Altman, 1992; Wolfe et al., 1993; Hiatt et al., 1994). T his can now be contemplated thanks to computerized virtual reality. The aim of our work, therefore, is to contribute to the elaboration of endo- scopic surgery simulators. To achieve this goal, a first step was to develop a prototypic ‘‘standard patient’’ on which the informatic and microengineering tools could be validated. We used the ‘‘visible man’’ dataset to generate a simulation for endoscopic cholecystectomy. Since this was the first nongynecological endoscopic procedure to be performed and therefore offers suffi- cient feedback (Filipi et al., 1991; McKernan, 1994), the present report describes the hepato-biliary anatomy of the visible man. MATERIALS AND METHODS The visible man dataset is a part of the visible human project initiated by the U.S. National Library of Medicine (NML) (Ackermann, 1995). It comprises 1,800 transverse cryosections at 1 mm intervals of a 39-year-old male subject, who had willed his body to the medical sciences. T his collection of images corre- *Correspondence to: Department of Morphology, University Medi- cal Center, 1 Rue M. Servet, CH-1211 Geneva, Switzerland. Received 10 June 1996; Revised 7 December 1996 Clinical Anatomy 10:389–393 (1997)  1997 Wiley-Liss, Inc.