Accuracy validation of an image guided laparoscopy system for liver resection

Abstract

We present an analysis of the registration component of a proposed image guidance system for image guided liver surgery, using contrast enhanced CT. The analysis is performed on a visually realistic liver phantom and in-vivo porcine data. A robust registration process that can be deployed clinically is a key component of any image guided surgery system. It is also essential that the accuracy of the registration can be quantified and communicated to the surgeon. We summarise the proposed guidance system and discuss its clinical feasibility. The registration combines an intuitive manual alignment stage, surface reconstruction from a tracked stereo laparoscope and a rigid iterative closest point registration to register the intra-operative liver surface to the liver surface derived from CT. Testing of the system on a liver phantom shows that subsurface landmarks can be localised to an accuracy of 2.9 mm RMS. Testing during five porcine liver surgeries demonstrated that registration can be performed during surgery, with an error of less than 10 mm RMS for multiple surface landmarks.

Electromagnetic tracking in image‐guided laparoscopic surgery: Comparison with optical tracking and feasibility study of a combined laparoscope and laparoscopic ultrasound system

“…The larger error is likely to be predominantly due to the point triangulation error when using a narrow‐baseline (approximately 4.5 mm) stereo laparoscope. This magnitude of error is in line with our previous work on point triangulation using a stereo laparoscope . Given the evidence in Tables and , we would expect optical trackers to be worse than EM trackers, largely due to the lever‐arm effect.…”

“…Both optical and EM-tracking systems exist for laparoscopy. 21,22 The group at Children's National Medical Center in Washington moved from an optically tracked to an EMtracked system 21,23 to reduce line-of-sight issues and ultimately to combine a laparoscope with a flexible LUS probe which necessitates EM tracking. However, in that work, 23 the EM sensor was placed on the distal end of the laparoscope, which must compound the poorer intrinsic level of accuracy of the EM tracker with the lever-arm effect, leading to suboptimal localization of the camera.…”

“…Both optical and EM‐tracking systems exist for laparoscopy . The group at Children's National Medical Center in Washington moved from an optically tracked to an EM‐tracked system to reduce line‐of‐sight issues and ultimately to combine a laparoscope with a flexible LUS probe which necessitates EM tracking.…”

Clinical application of a surgical navigation system based on virtual laparoscopy in laparoscopic gastrectomy for gastric cancer

“…Several research groups have developed experimental surgical navigation systems for laparoscopic surgery [8][9][10][11][12][13][14][15][16][17][18]. However, reports of their clinical use are very limited.…”

“…Translations are set manually so there is no attempt at 3D registration and hence 3D navigation. Papers [16][17][18] describe technical developments without clinical assessment. These papers describe surgical navigation based on an optically tracked mobile Carm [16], intraoperative ultrasound [17], and registration to surface patches reconstructed from a stereo laparoscope [18].…”