Real-time image guidance for robot-assisted laparoscopic surgery

肾癌是第六大最常见的恶性肿瘤，占加拿大癌症相关死亡的2.6%。2007年，有4,900名加拿大人被诊断患有肾癌，1,650人死于肾癌。最常见的肾癌手术是腹腔镜根治性肾切除术，包括切除整个肾脏;然而，另一种选择是腹腔镜肾部分切除术，仅允许切除包含肿瘤的肾脏部分。不幸的是，这是一个技术上具有挑战性的手术，有可能发生严重的并发症。该过程可以手动执行或在机器人辅助下执行。挑战仍然是在可视化的关键解剖隐藏从腹腔镜摄像机。这项研究的长期目标是开发将超声成像纳入机器人辅助腹腔镜检查的技术，以进行实时指导。特别是，这笔赠款将开发用于超声图像采集和分析的新技术，以提高机器人部分肾切除术治疗癌症的准确性，速度和成功率。患者的直接受益包括减少手术切缘阳性、保护重要结构免受损伤和提高患者生存率。这些技术将使用手术前和手术期间拍摄的多种类型的超声图像。用于肾切除术的机器人腹腔镜手术目前由立体摄像系统引导，因此结合超声和计算机断层扫描沿着关键解剖信息将为外科医生提供增强的指导。这种新方法将使肿瘤、血管、神经和实体器官的位置更准确地可视化。在这项研究中开发的工具将适用于其他团体进行机器人腹腔镜手术以及标准腹腔镜手术。主要研究领域包括图像配准、弹性成像、数据融合和手术用户界面。在本项目实施期间，将在这些领域培训7名高素质人员。

Kidney cancer is the sixth most frequently diagnosed malignancy overall, and is responsible for 2.6% of cancer-related death in Canada. In 2007, 4,900 Canadians were diagnosed with kidney cancer and 1,650 succumbed to it. The most commonly recruited procedure for kidney cancer is laparoscopic radical nephrectomy, which involves removal of the entire kidney; however, an alternative to this is laparoscopic partial nephrectomy which allows removal of only the segment of kidney containing the tumour. Unfortunately, this is a technically challenging operation with the potential for serious complications. This procedure can be performed manually or with robotic assistance. Challenges remain in visualizing the critical anatomy hidden from the laparoscopy camera. The long-term objective of this research is to develop the technology to incorporate ultrasound imaging into robotic assisted laparoscopy for real-time guidance. In particular, this grant will develop novel techniques for the acquisition and analysis of ultrasound images to improve the accuracy, speed and success of robotic partial nephrectomies for cancer treatment. Direct benefits to patients include reduction of positive surgical margins, preservation of vital structures from injury and increased patient survival. The techniques will use multiple types of ultrasound images taken before and during surgery. Robotic laparoscopic surgery for nephrectomy is currently guided by a stereo camera system, so incorporation of ultrasound and computed tomography, along with key anatomical information, will provide enhanced guidance for the surgeon. This new approach will enable more accurate visualization of the locations of tumours, blood vessels, nerves and solid organs. The tools developed in this research will be applicable to other groups performing robotic laparoscopic surgery as well as standard laparoscopic surgery. Key research areas include image registration, elastography, data fusion and surgical user interfaces. Seven highly qualified personnel will be trained in these areas over the period of this project.