Augmented Reality with Diffusion Tensor Imaging and Tractography during Laparoscopic Myomectomies

Area of Science:

• Minimally Invasive Surgery
• Medical Imaging Technology
• Gynecological Surgery

Background:

• Augmented reality (AR) overlays preoperative imaging onto real-time endoscopic views.
• Diffusion tensor imaging (DTI) and fiber tractography provide detailed subsurface structural information beyond standard MRI.
• Laparoscopic myomectomy is a common surgical procedure for uterine fibroids.

Observation:

• This study reports the first two cases using AR with DTI tractography-MRI during laparoscopic myomectomies.
• Preoperative MRI data was used to delineate uterine and myoma structures.
• A fiber tracking algorithm extrapolated uterine muscle fiber architecture.

Findings:

• AR successfully visualized subsurface uterine muscle fibers during surgery.
• The technology guided surgeons in determining the optimal starting incision point for myomectomy.
• The visualization of muscle fibers was achieved by blending aligned models with the endoscopic video feed.

Implications:

• This approach demonstrates the feasibility of AR and DTI fiber tracking in uterus with myomas.
• Visualizing muscle fiber orientation can enhance surgical precision in myomectomy.
• Adhering to fiber orientation may lead to improved scar quality and reduced uterine architectural disruption.