Robot-assisted prostate surgery using augmented reality with deformable models

描述（由申请人提供）：在本申请中，我们描述了我们提出的工作，即开发一种增强显示器，以改善机器人辅助前列腺手术中前列腺和周围关键解剖结构的可视化。前列腺癌是美国男性癌症相关死亡的第二大原因。据估计，2010年将有217,730名男性被诊断患有前列腺癌，32,050名男性将死于前列腺癌。大约六分之一的男性一生中会被诊断出患有前列腺癌，36人中会有一人死于这种疾病。早期前列腺癌有可能通过手术治愈，手术可以通过传统的开放方式或腹腔镜进行。近年来，机器人辅助腹腔镜根治性前列腺切除术（RALP）应用达芬奇(R)手术机器人系统得到了广泛的认可。机器人系统通过在工具末端加入额外的自由度来提高外科医生的灵活性，并提供更高的运动精度和稳定性。然而，由于手术是通过小切口进行的，与开放手术相比，这种技术减少了自由视觉和触觉反馈。外科医生也失去了触诊前列腺以定位肿瘤和其他关键结构（如神经血管束）的能力。外科医生必须依靠来自视频监视器的视觉线索，并在心理上将它们与潜在的解剖结构联系起来，通常使用手术前获得的医学图像信息。由于手术器械和前列腺组织之间的相互作用，前列腺组织在整个前列腺切除术过程中发生局部变形，从而引起进一步的并发症。随后，术前生成的解剖模型需要在手术过程中更新以反映这种变形。为了满足临床对更准确和可靠的指导需求，我们建议开发一种导航系统，为外科医生提供增强现实（AR）视图，该导航系统将术前前列腺、肿瘤和周围组织的MRI模型与达芬奇系统腹腔镜视频融合在一起，同时使用术中经直肠超声（TRUS）成像补偿非刚性前列腺组织变形。

DESCRIPTION (provided by applicant): In this application, we describe our proposed work to develop an augmented display for improved visualization of the prostate and surrounding critical anatomy for robot-assisted prostate surgery. Prostate cancer is the second leading cause of cancer-related deaths in men in the United States. It is estimated that 217,730 men will be diagnosed with and 32,050 men will die of cancer of the prostate in 2010. Approximately 1 man in 6 will be diagnosed with prostate cancer during his lifetime and 1 in 36 will die from the disease. Early stage prostate cancer is potentially cured by surgery, which can be performed in a traditional, open fashion or laparoscopically. Recently, robot-assisted laparoscopic radical prostatectomy (RALP) using the da Vinci(R) surgical robot system has gained wide acceptance. Robotic systems improve surgeon dexterity by incorporating additional degrees of freedom at the end of the tools and offer increased precision and stability of movements. However, since the procedure is performed through small incisions, this technique reduces free sight and tactile feedback compared to open surgery. Surgeons also lose the ability to palpate the prostate to locate tumors and other critical structures such as neurovascular bundles (NVB). Surgeons must rely on visual cues from the video monitor and mentally correlate them with the underlying anatomy, often using information from medical images obtained prior to the procedure. Further complications arise from local deformations in the prostate tissue that occurs throughout the prostatectomy procedure due to the interaction between the surgical instruments and the prostate tissue. Subsequently, the anatomical model generated pre-operatively will need to be updated during the procedure to reflect this deformation. To address the clinical need for more accurate and reliable guidance, we propose to develop a navigation system that provides surgeons with an augmented reality (AR) view that fuses a pre-operative MRI model of the prostate, tumor and surrounding tissues with the da Vinci system laparoscopic video, while compensating for non-rigid prostate tissue deformation using intra-operative transrectal ultrasound (TRUS) imaging. PUBLIC HEALTH RELEVANCE: Prostate cancer is the second leading cause of cancer-related deaths in men in the United States. It is estimated that 217,730 men will be diagnosed with and 32,050 men will die of cancer of the prostate in 2010. Early stage prostate cancer is potentially cured by surgery, which can be performed using robot-assistance. However, current robot technology does not offer accurate and reliable visual guidance system for surgeons. To address this need, we propose to develop an augmented reality display for improved visualization of the prostate and surrounding critical anatomy robot-assisted prostate surgery.