A clinical platform for ultrasound-augmented laparoscopy

摘要 该项目的总体目标是开发一种临床系统，该系统融合了腹腔镜视频和 用于增强腹腔镜手术的可视化和导航的腹腔镜超声。真正的- 使用腹腔镜获取的时间视频仍然是 全球每年进行的手术超过1400万例，但它显示了外科医生的手术器官 仅限曲面。腹腔镜超声可以显示内部结构，但通常显示在 单独的筛查，让外科医生进行两种模式的心理整合。这项任务是 低效的，主观的，和专业知识不同的。介绍了一种用于外科领域的针头 消融手术由于需要记录多个 用于理解三维空间关系和维护的信息来源 手眼协调。提出的实时数据融合，我们称之为增强现实 (AR)，以直观的方式向运营团队提供补充信息。研究， 在这个拟议的项目之前的开发和临床翻译工作已经证明 所提出的AR可视化和导航的技术可行性和临床实用价值。这支队伍有 成功地开发了研究原型，并在11例人类病例中使用了最新的原型 不同的手术中心。这一建议是从我们的临床经验中得出的 建立临床系统的翻译经验。需要改进的主要领域包括 降低系统复杂性和尺寸，提高可靠性和临床可行性。全国少年儿童 医院和Terason将合作开发定制的专业腹腔镜超声 换能器和提供AR作为商业超声的集成高级应用 站台。该项目的具体目标是：1)开发定制的跟踪式腹腔镜超声 传感器，2)开发集成跟踪和AR的商业级超声系统 技术，以及3)对开发的系统进行临床前评估。我们的科学前提是 术中正常和病理解剖的全面可视化和导航 消融针的引导将提高目前流行的腹腔镜手术的精度、安全性和效率。 程序，并扩大它们的使用。拟议的学术-产业合作伙伴关系旨在 以便通过开发可供常规使用的临床系统来实现这些好处 在世界各地的手术室里。

SUMMARY The overall objective of this project is to develop a clinical system that fuses laparoscopic video and laparoscopic ultrasound for enhanced visualization and navigation of laparoscopic procedures. Real- time video acquired using a laparoscope remains the primary visualization and guidance modality in over 14 million procedures performed per year globally, but it shows the operating surgeon organ surfaces only. Laparoscopic ultrasound can show internal structures, but is often displayed on a separate screen, leaving the surgeon to perform a mental integration of the 2 modalities. This task is inefficient, subjective, and variable with expertise. Introduction of a needle in the surgical field for ablative procedures further increases the surgeon's cognitive load by needing to register multiple sources of information for understanding three-dimensional spatial relationships and for maintaining hand-eye coordination. The proposed real-time data fusion, which we refer to as augmented reality (AR), presents complementary information to the operating team in an intuitive way. Research, development, and clinical translation efforts preceding this proposed project have demonstrated the technical feasibility and clinical utility of the proposed AR visualization and navigation. The team has successfully developed research prototypes and used the most recent prototype in 11 human cases at 2 different surgical centers. This proposal is borne out of the real-world lessons from our clinical translation experience toward building a clinical system. The major areas of improvement include reducing system complexity and size and improving reliability and clinical viability. Children's National Hospital and Terason will collaborate to develop custom specialized laparoscopic ultrasound transducers and offer AR as a well-integrated advanced application on a commercial ultrasound platform. The specific aims for this project are to 1) develop custom tracked laparoscopic ultrasound transducers, 2) develop a commercial-grade ultrasound system with integrated tracking and AR technologies, and 3) conduct preclinical evaluation of the developed system. Our scientific premise is that comprehensive intraoperative visualization of normal and pathological anatomy and navigated guidance of ablation needles will improve the precision, safety, and efficiency of prevailing laparoscopic procedures, and expand their utilization. The proposed academic-industrial partnership is designed such that these benefits are realized through the development of a clinical system ready for routine use in the operating rooms worldwide.