Registration-free laparoscope augmentation for intra-operative liver resection planning

Marco Feuerstein; Thomas Mussack; Sandro M. Heining; Nassir Navab

doi:10.1117/12.706766

21 March 2007 Registration-free laparoscope augmentation for intra-operative liver resection planning

Marco Feuerstein, Thomas Mussack, Sandro M. Heining, Nassir Navab

Proceedings Volume 6509, Medical Imaging 2007: Visualization and Image-Guided Procedures; 650915 (2007) https://doi.org/10.1117/12.706766
Event: Medical Imaging, 2007, San Diego, CA, United States

Abstract

In recent years, an increasing number of liver tumor indications were treated by minimally invasive laparoscopic resection. Besides the restricted view, a major issue in laparoscopic liver resection is the enhanced visualization of (hidden) vessels, which supply the tumorous liver segment and thus need to be divided prior to the resection. To navigate the surgeon to these vessels, pre-operative abdominal imaging data can hardly be used due to intraoperative organ deformations mainly caused by appliance of carbon dioxide pneumoperitoneum and respiratory motion. While regular respiratory motion can be gated and synchronized intra-operatively, motion caused by pneumoperitoneum is individual for every patient and difficult to estimate. Therefore, we propose to use an optically tracked mobile C-arm providing cone-beam CT imaging capability intraoperatively. The C-arm is able to visualize soft tissue by means of its new flat panel detector and is calibrated offline to relate its current position and orientation to the coordinate system of a reconstructed volume. Also the laparoscope is optically tracked and calibrated offline, so both laparoscope and C-arm are registered in the same tracking coordinate system. Intra-operatively, after patient positioning, port placement, and carbon dioxide insufflation, the liver vessels are contrasted and scanned during patient exhalation. Immediately, a three-dimensional volume is reconstructed. Without any further need for patient registration, the volume can be directly augmented on the live laparoscope video, visualizing the contrasted vessels. This augmentation provides the surgeon with advanced visual aid for the localization of veins, arteries, and bile ducts to be divided or sealed.

Citation Download Citation

Marco Feuerstein, Thomas Mussack, Sandro M. Heining, and Nassir Navab "Registration-free laparoscope augmentation for intra-operative liver resection planning", Proc. SPIE 6509, Medical Imaging 2007: Visualization and Image-Guided Procedures, 650915 (21 March 2007); https://doi.org/10.1117/12.706766

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