Navigated ultrasound in laparoscopic surgery

Area of Science:

• Minimally Invasive Surgery
• Medical Imaging
• Surgical Navigation

Background:

• Laparoscopic surgery's limited visibility and palpation hinder precise organ assessment.
• Current endoscopic tools lack subsurface information, crucial for procedural accuracy.
• Intraoperative ultrasound offers real-time internal organ data, vital for surgical guidance.

Purpose of the Study:

• To develop and evaluate a prototype 3D laparoscopic ultrasound navigation system.
• To assess the system's accuracy in providing real-time intraoperative imaging.
• To investigate the potential of integrating 3D ultrasound with preoperative CT data for enhanced surgical navigation.

Main Methods:

• Integration of micro-positioning sensors with a flexible intraoperative ultrasound probe for 3D data acquisition.
• Development of a prototype navigation system combining 2D/3D ultrasound with 3D CT data.
• Evaluation of optical and electromagnetic tracking systems for probe and instrument localization in a laboratory and operating room setting.

Main Results:

• The 3D laparoscopic ultrasound solution achieved average volume deviations of 1.6% to 3.6% from phantom specifications.
• Electromagnetic tracking in the operating room showed an increase in RMS distance error from 0.3 mm to 2.3 mm due to environmental interference.
• Tracked surgical tools enabled interactive control of registered preoperative images and intraoperative 3D ultrasound data.

Conclusions:

• The developed 3D laparoscopic ultrasound navigation system demonstrates accuracy and potential for improving surgical guidance.
• Despite electromagnetic tracking interferences, the system shows promise for enhancing safety in minimally invasive procedures.
• Interactive control of multimodal imaging data (CT and 3D ultrasound) can significantly aid surgeons in complex operations.