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Keyhole-aware laparoscopic augmented reality.

Yamid Espinel1, Navid Rabbani1, Thien Bao Bui2

  • 1Université Clermont Auvergne, 28 place Henri Dunant, 63000 Clermont-Ferrand, France; Centre Hospitalier Universitaire de Clermont-Ferrand, 58 rue Montalembert, 63000 Clermont-Ferrand, France.

Medical Image Analysis
|April 4, 2024
PubMed
Summary
This summary is machine-generated.

Augmented reality (AR) for laparoscopic liver resection (LLR) can misguide surgeons. A new keyhole-aware AR system accurately projects tumor location to improve surgical accuracy for deep tumors.

Keywords:
Augmented realityEndoscopyLiverSurgical guidance

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Area of Science:

  • Medical Imaging
  • Surgical Navigation
  • Computer-Assisted Surgery

Background:

  • Augmented Reality (AR) enhances intraoperative tumor localization in Laparoscopic Liver Resection (LLR) by registering preoperative data with live laparoscopic views.
  • Current AR systems project preoperative tumor models directly onto laparoscopic images, which can lead to surgeon misguidance due to differing entry points of instruments and the laparoscope.

Purpose of the Study:

  • To address the misguidance issue in AR-guided LLR by developing a keyhole-aware visualization pipeline.
  • To accurately estimate and visualize the tool's keyhole position in laparoscope coordinates for improved AR guidance.

Main Methods:

  • A novel keyhole-aware pipeline was developed to estimate the tool's keyhole position by observing the surgical tool.
  • The system projects the tumor from its internal position to the liver surface towards the tool's keyhole, then to the camera.
  • Keyhole-aware visualization of the tumor was implemented.

Main Results:

  • Quantitative assessment on in silico and liver phantom models demonstrated the pipeline's effectiveness.
  • Qualitative evaluation using three patient datasets confirmed the benefits of the keyhole-aware approach.
  • The proposed method successfully resolves the tool keyhole position estimation problem.

Conclusions:

  • The developed keyhole-aware AR pipeline significantly improves the accuracy of intraoperative tumor localization in LLR.
  • This approach mitigates surgeon misguidance, enhancing the utility of AR for deep-seated tumors in LLR.
  • The system offers a promising advancement for AR-guided minimally invasive liver surgery.