A surgical navigation system for aortic vascular surgery: a practical approach.

Area of Science:

• Biomedical Engineering
• Medical Imaging
• Surgical Navigation

Background:

• Accurate patient-specific anatomical representation is crucial for aortic vascular surgery to identify vital arteries.
• Current navigation systems rely on a limited set of anterior body landmarks.
• Variations in tissue thickness can introduce alignment errors, impacting registration accuracy.

Purpose of the Study:

• To enhance the accuracy of patient-specific anatomical mapping for aortic vascular surgery.
• To improve the fit of anatomical models along the dorsoventral axis by incorporating the spinous process.
• To reduce registration errors by compensating for tissue thickness variations.

Main Methods:

• A spinous process landmark was added to a set of four anterior body landmarks.
• A compensation method was developed for alignment errors due to tissue thickness variations.
• A human phantom with a skeleton model and subcutaneous tissue was used for examination.
• Phantom simulations and five clinical trials were conducted.
• Target errors were evaluated at the intercostal artery orifice.

Main Results:

• Phantom simulations demonstrated a target error of 4.1 ± 2.7 mm.
• Clinical trials were performed on patients undergoing aortic aneurysm repair.
• One patient undergoing thoracoabdominal aortic aneurysm replacement surgery showed a target error of 8.0 mm using the proposed method.

Conclusions:

• The addition of the spinous process and compensation for tissue thickness show potential for improving anatomical mapping in aortic vascular surgery.
• Further validation and refinement are necessary to minimize target errors in clinical applications.
• The enhanced anatomical model aims to improve the precision of surgical navigation systems.