Navigation and Augmented Reality for Liver Surgery

Correia, Mauro Monteiro

doi:10.1007/978-3-030-25486-5_30

Colorectal Cancer Liver Metastases 2019

DOI: 10.1007/978-3-030-25486-5_30

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Navigation and Augmented Reality for Liver Surgery

Mauro Monteiro Correia

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Cited by 2 publications

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“…[10][11][12] As an alternative or addition to using IOUS, navigation techniques can be used. 13 In a common navigation setting, the surgeon has a tracked object (e.g., pointer or forceps) of which the location is visualized ''real-time'' on a screen, relative to the patient's anatomy in preoperative imaging. Anticipating on what is visualized while moving the tracked object, the surgeon can locate the lesion in the actual anatomy and assess its borders.…”

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“…14 Most techniques compensating for this effect try to estimate the new lesion location by detecting and modeling the anatomical changes. 13,15,16 However, a more straight-forward approach is to track the lesion motion directly, using trackers implanted near or in the lesion. Studies on lesion tracking using electromagnetic (EM) trackers have shown promising results.…”

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confidence: 99%

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Real-Time Wireless Tumor Tracking in Navigated Liver Resections: An Ex Vivo Feasibility Study

et al. 2022

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Background Surgical navigation systems generally require intraoperative steps, such as intraoperative imaging and registration, to link the system to the patient anatomy. Because this hampers surgical workflow, we developed a plug-and-play wireless navigation system that does not require any intraoperative steps. In this ex vivo study on human hepatectomy specimens, the feasibility was assessed of using this navigation system to accurately resect a planned volume with small margins to the lesion. Methods For ten hepatectomy specimens, a planning CT was acquired in which a virtual spherical lesion with 5 mm margin was delineated, inside the healthy parenchyma. Using two implanted trackers, the real-time position of this planned resection volume was visualized on a screen, relative to the used tracked pointer. Experienced liver surgeons were asked to accurately resect the nonpalpable planned volume, fully relying on the navigation screen. Resected and planned volumes were compared using CT. Results The surgeons resected the planned volume while cutting along its border with a mean accuracy of − 0.1 ± 2.4 mm and resected 98 ± 12% of the planned volume. Nine out of ten resections were radical and one case showed a cut of 0.8 mm into the lesion. The sessions took approximately 10 min each, and no considerable technical issues were encountered. Conclusions This ex vivo liver study showed that it is feasible to accurately resect virtual hepatic lesions with small planned margins using our novel navigation system, which is promising for clinical applications where nonpalpable hepatic metastases have to be resected with small resection margins.

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Real-Time Wireless Tumor Tracking in Navigated Liver Resections: An Ex Vivo Feasibility Study

et al. 2022

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An improved camera model for oblique-viewing laparoscopes: high reprojection accuracy independent of telescope rotation

Eppenga,

Snaauw,

Kuhlmann

et al. 2023

Phys. Med. Biol.

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ObjectiveOblique-viewing laparoscopes are popular in laparoscopic surgeries where the target anatomy is located in narrow areas. Their viewing direction can be shifted by telescope rotation without changing the laparoscope pose. This rotation also changes laparoscope camera parameters that are estimated by camera calibration to be able to reproject an anatomical model onto the laparoscopic view, creating augmented reality (AR). The aim of this study was to develop a camera model that accounts for these changes, achieving high reprojection accuracy for any telescope rotation. ApproachCamera parameters were acquired by calibrations encompassing a wide telescope rotation range. For those parameters showing periodic changes upon rotation, interpolation models were created and used to establish an updatable camera model. With this model, corner points of a tracked checkerboard were reprojected onto the checkerboard laparoscopic images, at random rotation angles. Root-mean-square reprojection errors (RMSEs) were calculated between the reprojected and imaged corner points.Main resultsReprojection RMSEs were low and approximately independent on telescope rotation angle, over a wide rotation range of 320 degrees. The mean reprojection RMSE was 2.8±0.7 pixels for a conventional laparoscope and 3.6±0.7 pixels for a chip-on-the-tip laparoscope, corresponding to 0.3±0.1mm and 0.4±0.1mm in world coordinates respectively. Worst-case reprojection errors were about 9 pixels (0.8mm) for both laparoscopes.SignificanceThe camera model developed in this study improves on existing models for oblique-viewing laparoscopes because it provides high reprojection accuracy independent of the telescope rotation angle and is applicable for conventional and chip-on-a-tip oblique-viewing laparoscopes. The work presented here is an important step towards creating accurate AR in image-guided interventions where oblique-viewing laparoscopes are used while simultaneously providing the surgeon the flexibility to rotate the telescope to any desired rotation angle.

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Navigation and Augmented Reality for Liver Surgery

Cited by 2 publications

References 32 publications

Real-Time Wireless Tumor Tracking in Navigated Liver Resections: An Ex Vivo Feasibility Study

Real-Time Wireless Tumor Tracking in Navigated Liver Resections: An Ex Vivo Feasibility Study

An improved camera model for oblique-viewing laparoscopes: high reprojection accuracy independent of telescope rotation

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