In-vitro evaluation of a soft-tissue navigation system for laparoscopic prostatectomy

Area of Science:

• Medical Imaging
• Surgical Navigation
• Augmented Reality

Background:

• Prostate interventions require precise navigation.
• Existing systems face challenges with soft-tissue deformation and motion.
• Augmented reality (AR) offers potential for enhanced surgical visualization.

Purpose of the Study:

• To evaluate an AR-based soft-tissue navigation system for ultrasound-guided prostate interventions.
• To introduce a custom-designed phantom model for in-vitro testing.
• To assess the system's accuracy in tracking prostate motion.

Main Methods:

• Developed a custom phantom model for in-vitro evaluation.
• Utilized transrectal ultrasound for prostate segmentation and navigation aid placement.
• Employed a leave-out test strategy with navigation aids for registration and verification.
• Simulated laparoscopic procedures on human prostate specimens.

Main Results:

• Navigation aid introduction averaged 3 minutes, with good ultrasound visibility.
• Demonstrated automatic following of the superimposed AR image to the real-time videoendoscopic view.
• Achieved mean target visualization errors of 0.81 (±0.12) mm, 0.62 (±0.14) mm, and 0.98 (±0.23) mm.

Conclusions:

• The ultrasound-based inside-out navigation system effectively addresses tissue shift and deformation in an in-vitro model.
• The AR system, using navigation aids as landmarks, accurately follows the videoendoscopic image during organ movement.
• This technology shows promise for improving accuracy in laparoscopic prostatectomy.