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Surgical planning is normally based on preoperative imaging. The position, shape, and volume of the abdominal organs change during laparoscopy, which challenges image registration and reduces surgical precision. This study aims to analyze the morphological changes of the liver and spleen from pre- to intraoperative (with pneumoperitoneum) computed tomography (CT) images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used portal venous phase pre- and intraoperative CT images from 15 patients who underwent laparoscopic liver ablation in general anesthesia under 12\u00a0mmHg pneumoperitoneum at Rikshospitalet, Oslo University Hospital, Oslo, Norway. A rigid registration, based on spinal landmarks, was used to register intraoperative to preoperative CT images. Morphological features were extracted and statistically analyzed for the liver and spleen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The liver volume decreased by 12% from\u00a0the preoperative to the\u00a0intraoperative CT\u00a0scan. The mean cranial movement of the liver was 45\u00a0mm between pre- and intraoperative CT images. A few morphological radiomic features changed significantly for both liver and spleen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To the best of our knowledge, this is the first published study in humans to analyze the morphological changes of the liver and spleen during pneumoperitoneum. The results show a significant reduction in liver volume and change in shape and position of the liver during such laparoscopy. This deformation from preoperative to intraoperative imaging poses significant challenges for image registration, which is crucial for surgical navigation. These findings  highlight the need for updated intraoperative navigation using imaging and registration to ensure accurate  surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-025-12392-y","type":"journal-article","created":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T13:53:28Z","timestamp":1763906008000},"page":"1458-1468","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Morphological changes on the human liver during minimally invasive surgery: Implications for image-guided interventions and surgical navigation"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9582-8844","authenticated-orcid":false,"given":"Varatharajan","family":"Nainamalai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e5vard Bj\u00f8rke","family":"Jenssen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Boretto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil Pramod","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas Westenvik","family":"Espinoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egidijus","family":"Pelanis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e5rd I.","family":"R\u00f8sok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Jakob","family":"Elle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid Schr\u00f8der","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f8rn","family":"Edwin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c5smund Avdem","family":"Fretland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"issue":"1","key":"12392_CR1","doi-asserted-by":"publisher","DOI":"10.1080\/24699322.2024.2357164","volume":"29","author":"Z Han","year":"2024","unstructured":"Han Z, Dou Q (2024) A review on organ deformation modeling approaches for reliable surgical navigation using augmented reality. 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