Efficiency, Accuracy and Clinical Applicability of a New Image-Guided Surgery System in 3D Laparoscopic Liver Surgery.

Prevost, Gian Andrea; Eigl, Benjamin; Paolucci, Iwan; Rudolph, Tobias; Peterhans, Matthias; Weber, Stefan; Beldi, Guido; Candinas, Daniel; Lachenmayer, Anja (2019). Efficiency, Accuracy and Clinical Applicability of a New Image-Guided Surgery System in 3D Laparoscopic Liver Surgery. (In Press). Journal of gastrointestinal surgery Springer-Verlag 10.1007/s11605-019-04395-7

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BACKGROUND To investigate efficiency, accuracy and clinical benefit of a new augmented reality system for 3D laparoscopic liver surgery. METHODS All patients who received laparoscopic liver resection by a new image-guided surgery system with augmented 3D-imaging in a university hospital were included for analysis. Digitally processed preoperative cross-sectional imaging was merged with the laparoscopic image. Intraoperative efficiency of the procedure was measured as time needed to achieve sufficient registration accuracy. Technical accuracy was reported as fiducial registration error (FRE). Clinical benefit was assessed trough a questionnaire, reporting measures in a 5-point Likert scale format ranging from 1 (high) to 5 (low). RESULTS From January to March 2018, ten laparoscopic liver resections of a total of 18 lesions were performed using the novel augmented reality system. Median time for registration was 8:50 min (range 1:31-23:56). The mean FRE was reduced from 14.0 mm (SD 5.0) in the first registration attempt to 9.2 mm (SD 2.8) in the last attempt. The questionnaire revealed the ease of use of the system (1.2, SD 0.4) and the benefit for resection of vanishing lesions (1.0, SD 0.0) as convincing positive aspects, whereas image registration accuracy for resection guidance was consistently judged as too inaccurate. CONCLUSIONS Augmented reality in 3D laparoscopic liver surgery with landmark-based registration technique is feasible with only little impact on the intraoperative workflow. The benefit for detecting particularly vanishing lesions is high. For an additional benefit during the resection process, registration accuracy has to be improved and non-rigid registration algorithms will be required to address intraoperative anatomical deformation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Image Guided Therapy

UniBE Contributor:

Prevost, Gian Andrea; Eigl, Benjamin Peter; Paolucci, Iwan; Weber, Stefan; Beldi, Guido; Candinas, Daniel and Lachenmayer, Anja

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1091-255X

Publisher:

Springer-Verlag

Language:

English

Submitter:

Lilian Karin Smith-Wirth

Date Deposited:

05 Feb 2020 09:04

Last Modified:

18 Feb 2020 08:49

Publisher DOI:

10.1007/s11605-019-04395-7

PubMed ID:

31621024

Uncontrolled Keywords:

3D Augmented reality Image-guided surgery Laparoscopy Liver

BORIS DOI:

10.7892/boris.139429

URI:

https://boris.unibe.ch/id/eprint/139429

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