access icon openaccess Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery

In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm3 (p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm (p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

Inspec keywords: calibration; kidney; biomedical ultrasonics; medical robotics; surgery; cancer; augmented reality; tumours

Other keywords: robot-assisted partial nephrectomies; kidney; healthy parenchymal tissue; surgical instrument tracking; tumour excision; single navigation aid; intra-operative ultrasound-based augmented reality guidance; robot-to-camera calibration; endophytic tumour; laparoscopic surgery; registration error

Subjects: Interactive-input devices; Virtual reality; Sonic and ultrasonic radiation (medical uses); Measurement standards and calibration; Patient care and treatment; Patient care and treatment; Biological and medical control systems; Sonic and ultrasonic applications; Measurement standards and calibration; Sonic and ultrasonic radiation (biomedical imaging/measurement); Robotics

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http://iet.metastore.ingenta.com/content/journals/10.1049/htl.2017.0063
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