Robust augmented reality guidance with fluorescent markers in laparoscopic surgery
Robust augmented reality guidance with fluorescent markers in laparoscopic surgery
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DOI：
10.1007/s11548-016-1385-4
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发表时间：
2016-06-01
影响因子：
3
通讯作者：
Maier-Hein, Lena
中科院分区：
文献类型：
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作者：
Wild, Esther;Teber, Dogu;Maier-Hein, Lena
腹腔镜手术需要医疗器械在患者体内精确导航，同时考虑到关键结构。尽管已经提出了许多概念用于使用增强现实来显示表面下解剖细节，但是这些方法的临床转化遭受了缺乏鲁棒性以及到临床工作流程中的繁琐集成。本研究的目的是探讨一种新的方法的可行性，术中配准的基础上的荧光markers.The增强现实可视化的方法依赖于代谢荧光标记，附着到靶器官，以指导2D/3D术中配准算法。在离体猪研究中，在内窥镜视野中存在烟雾、血液和组织的情况下评估标记物跟踪性能。与最先进的针形基准标记物相比，荧光标记物在被烟雾、血液或组织遮挡时可以可靠地跟踪。这使得新的2D/3D术中配准方法比最先进的基于标记的方法更加鲁棒。由于该概念可以顺利地集成到临床工作流程中，因此其在临床腹腔镜检查中的应用潜力很高。
Laparoscopic interventions require the precise navigation of medical instruments through the patient's body, while taking critical structures into account. Although numerous concepts have been proposed for displaying subsurface anatomical detail using augmented reality, clinical translation of these methods has suffered from a lack of robustness as well as from cumbersome integration into the clinical workflow. The purpose of this study was to investigate the feasibility of a new approach to intra-operative registration based on fluorescent markers.The proposed approach to augmented reality visualization relies on metabolizable fluorescent markers that are attached to the target organ to guide a 2D/3D intra-operative registration algorithm. In an ex vivo porcine study, marker tracking performance is evaluated in the presence of smoke, blood, and tissue in the field of view of the endoscope.In contrast to state-of-the-art needle-shaped fiducial markers, the fluorescent markers can be reliably tracked when occluded by smoke, blood or tissue. This makes the new 2D/3D intra-operative registration approach considerably more robust than state-of-the-art marker-based methods.As the concept can be smoothly integrated into the clinical workflow, its potential for application in clinical laparoscopy is high.