Image-guided laparoscopic surgery in an open MRI operating theater

Area of Science:

• Medical Imaging
• Surgical Navigation
• Minimally Invasive Surgery

Background:

• Open magnetic resonance imaging (MRI) systems offer new possibilities for image-guided surgical procedures.
• The integration of advanced imaging into operating rooms is crucial for enhancing surgical precision.

Purpose of the Study:

• To evaluate the feasibility of performing laparoscopic surgery under pneumoperitoneum within an open MRI operating theater.
• To assess the utility of a novel augmented reality navigation system in conjunction with open MRI for laparoscopic procedures.

Main Methods:

• Five patients underwent laparoscopic surgery utilizing a previously developed real-time augmented reality navigation system.
• Procedures were conducted within a horizontal-type 0.4-Tesla open MRI operating theater.

Main Results:

• All surgeries were successfully completed in the open MRI environment.
• Augmented reality models of intraperitoneal structures and prosthesis placement were clearly visualized on the laparoscopic monitor.
• The navigation system achieved a frame rate of 8 frames per minute with a mean fiducial registration error of 6.88 ± 6.18 mm.
• Magnetic resonance-incompatible instruments were usable outside the 5-Gauss restriction area.

Conclusions:

• Laparoscopic surgery integrated with a real-time augmented reality navigation system in an open MRI operating theater is a viable approach.
• This combination enhances surgical visualization and allows for the use of specialized instruments within the MRI environment.