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who are in pursuit of change in medical practice. According to the Web of Science (accessed February
2021), the paper has been cited 184 times. However, Marescaux and his team were not the only
representatives of this avant-garde. Many others wanted to become a part of the surgical innovation
movement, too.

Since that time, information technology, augmented reality, virtual reality, 3D printing and other similar
[2]
technologies have changed medicine . Many ideas have already been implemented, while others are being
rapidly developed. Surgical innovation has always been fundamental to surgical progress , and it seems
[3]
even more apparent at present.

The practice of surgery is changing, and the technological impact can be clearly seen during surgical
[4]
teaching and learning, as noted by Langridge et al. . Additive manufacturing has become a fascinating
research topic in anatomy education, surgical training and preoperative planning. Even though this research
field is still in its infancy from the point of view of clinical outcomes, technology’s impact will probably
change the surgical landscape very soon. Technology is becoming cheaper and hence readily available. For
instance, Witowski et al. proposed in 2017 a cost-effective liver model printed using fused deposition
[5]
modelling technology. The costs of printing are less than $150. Witowski was still a medical student at the
time he published these findings.

In 2011, a new concept of so-called precision medicine emerged and was published by the National
Research Council of the United States . In this model, clinical treatment decisions and other practices are
[6]
matched to a specific patient or a particular subgroup of patients. The treatment is customised to the
patient, and the surgery is tailored to the patient as well. However, the idea of precision liver surgery has
been around for a bit longer. Dong et al. made the scientific community aware of the need for a paradigm
[7]
shift in liver surgery for the first time in 2006. He called this idea “precision liver resection” , but it later
[8]
evolved to the term “precision liver surgery” .
[9]
The COVID-19 pandemic has further increased the speed of changes and implementation of telemedicine
and other digital technologies. Thus, we can observe more adoption and translation of technology into
healthcare.

Inevitably, the old “see one, do one, teach one” paradigm has been shifting [10,11] . Now, it seems to be the 4Ps:
plan, prepare, perform and perfect.

This systematic review aims to present studies on computer-aided surgical methods used in paediatric liver
surgery, discuss the scientific methods used and provide new perspectives on preoperative planning. This
review also aims to discuss progress of the radiological assessment. This paper is organised according to the
following sections: plan (radiological assessment), prepare and perform (systematic review) and perfect
(discussion).

METHODS
A comprehensive, focused literature search was conducted and performed according to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses Guidelines .
[12]

Data sources
We performed a systematic search using our search strategy in MEDLINE®, PubMed®, EMBASE and Ovid
scientific electronic databases. The keywords were selected based on a recently published mapping of