One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-operative morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon's navigation capabilites by observing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted instruments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D optical imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions.
Recent advances in surgical robotics have provided a platform for extending the current capabilities of minimally invasive surgery by incorporating both pre-operative and intra-operative imaging data. In this tutorial paper, we introduce techniques for in vivo 3D tissue deformation recovery and tracking, based on laparoscopic or endoscopic images. These optically based techniques provide a unique opportunity for recovering surface deformation of the softtissue without the need of additional instrumentation. They can therefore be easily incorporated into the existing surgical workflow. Technically, the problem formulation is challenging due to non-rigid deformation of the tissue and instrument interaction. Current approaches and future research directions in terms of intra-operative planning and adaptive surgical navigation are explained in detail.Index Terms-image-guidance, robotic assisted minimally invasive surgery, 3D deformation recovery.
Real-time CMR-guided LV lead placement is feasible and achievable in a single clinical setting and may prove helpful to preferentially select sites for LV lead placement.
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