Follow the light: projector-based augmented reality intracorporeal system for laparoscopic surgery

Area of Science:

• Minimally Invasive Surgery
• Medical Imaging
• Surgical Navigation Systems

Background:

• Laparoscopic partial nephrectomy (LPN) requires precise tumor identification and dissection.
• Current guidance methods like laparoscopic ultrasound (LUS) have limitations in visualizing tumor margins.
• Improving surgical accuracy and reducing damage to healthy tissue are key goals in LPN.

Purpose of the Study:

• To introduce and evaluate a projector-based augmented reality intracorporeal system (PARIS) for LPN.
• To assess PARIS's effectiveness in improving tumor boundary identification and anatomical understanding during LPN.
• To quantify the impact of PARIS on surgical metrics such as healthy tissue excision and margin status.

Main Methods:

• Development of PARIS, integrating a miniature tracked projector, tracked marker, and LUS transducer.
• Performance evaluation through a user study involving two surgeons performing simulated robot-assisted partial nephrectomies.
• Comparison of 16 LPN simulations with PARIS guidance versus 16 LPN simulations with LUS guidance alone.

Main Results:

• PARIS demonstrated a significant 30% reduction in healthy tissue excised compared to LUS alone.
• A trend towards more accurate tumor dissection and improved negative margin rates was observed with PARIS.
• The system achieved a combined point tracking and reprojection root-mean-square error of 0.8 mm.

Conclusions:

• The projector-based augmented reality intracorporeal system (PARIS) is an effective surgical navigation tool for LPN.
• PARIS improves key surgical metrics, including reduced healthy tissue excision and enhanced dissection accuracy.
• Surgeon feedback supports PARIS's utility in improving surgical efficacy and safety during LPN.