Development of real-time navigation system for laparoscopic hepatectomy using magnetic micro sensor

Area of Science:

• Surgical Navigation
• Medical Imaging
• Minimally Invasive Surgery

Background:

• Laparoscopic hepatectomy (LH) presents navigation challenges.
• A real-time navigation system, analogous to automotive GPS, is proposed.
• The system utilizes virtual 3D liver and body imaging for intraoperative guidance.

Purpose of the Study:

• To develop and evaluate a novel real-time navigation system for laparoscopic hepatectomy.
• To assess the accuracy and potential of the system in guiding surgical procedures.
• To improve the precision and safety of LH through virtual image guidance.

Main Methods:

• Virtual 3D liver and body images reconstructed using the "New-VES" system.
• Patient body points registered to virtual images via magnetic position sensors (MPS).
• Fiducial registration error (FRE) used to quantify system accuracy.

Main Results:

• Initial mean FRE was 17.7 mm, reduced to 10.2 mm with MDCT registration improvements (p=0.014).
• Further refinement with an intraoperative body position sensor yielded mean FREs of 11.1 mm (preoperative) and 10.1 mm (postoperative) (p=0.250).
• The system was applied in 21 patients undergoing LH.

Conclusions:

• The developed navigation system shows promise for virtually guiding laparoscopic hepatectomy.
• Improvements in registration techniques significantly enhanced system accuracy.
• The system offers a potential advancement in minimally invasive liver surgery.