Towards scarless surgery:: An endoscopic ultrasound navigation system for transgastric access procedures
Towards scarless surgery:: An endoscopic ultrasound navigation system for transgastric access procedures
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DOI：
10.1080/10929080701746892
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发表时间：
2007-11-01
影响因子：
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通讯作者：
Vosburgh, Kirby
中科院分区：
文献类型：
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作者：
Estepar, Raul San Jose;Stylopoulos, Nicholas;Vosburgh, Kirby
目的：无疤痕手术是一种创新的、有前途的技术，它可能预示着外科手术的一个新纪元。我们已经创建了一种名为IRGUS的导航系统，用于内窥镜和经胃介入治疗，并在体内先导研究中进行了验证。我们的假设是，如果操作员实时获得与探头位置和超声图像相对应的近似配准的3D和2D处理的CT图像，则内窥镜超声操作将更加容易和高效。材料和方法：系统提供增强的视觉反馈和附加的上下文信息来帮助操作员。它在实时内窥镜超声图像和使用内窥镜超声探头位置的电磁跟踪记录的术前CT体积之间建立对应。结果：该系统减轻了探头导航的心理负担，提高了操作人员对超声图像的理解能力。使用初始刚体配准，我们测量了超声图像和重建的CT平面之间的错误配准误差小于5 mm，这足以使内窥镜系统的新手用户的性能接近专家用户的性能。结论：我们的分析表明，使用刚性配准的数据实时显示足够准确，可以辅助外科医生进行内窥镜腹部手术。通过使用术前数据为图像解释和靶向实时成像提供背景和支持，术前和术中数据似乎都可能用于改善操作者的表现。
Objective: Scarless surgery is an innovative and promising technique that may herald a new era in surgical procedures. We have created a navigation system, named IRGUS, for endoscopic and transgastric access interventions and have validated it in in vivo pilot studies. Our hypothesis is that endoscopic ultrasound procedures will be performed more easily and efficiently if the operator is provided with approximately registered 3D and 2D processed CT images in real time that correspond to the probe position and ultrasound image.Materials and Methods: The system provides augmented visual feedback and additional contextual information to assist the operator. It establishes correspondence between the real-time endoscopic ultrasound image and a preoperative CT volume registered using electromagnetic tracking of the endoscopic ultrasound probe position. Based on this positional information, the CT volume is reformatted in approximately the same coordinate frame as the ultrasound image and displayed to the operator.Results: The system reduces the mental burden of probe navigation and enhances the operator's ability to interpret the ultrasound image. Using an initial rigid body registration, we measured the mis-registration error between the ultrasound image and the reformatted CT plane to be less than 5 mm, which is sufficient to enable the performance of novice users of endoscopic systems to approach that of expert users.Conclusions: Our analysis shows that real-time display of data using rigid registration is sufficiently accurate to assist surgeons in performing endoscopic abdominal procedures. By using preoperative data to provide context and support for image interpretation and real-time imaging for targeting, it appears probable that both preoperative and intraoperative data may be used to improve operator performance.