A clinical platform for ultrasound-augmented laparoscopy

总结 该项目的总体目标是开发一种融合腹腔镜视频和 腹腔镜超声用于增强腹腔镜手术的可视化和导航。真实的- 使用腹腔镜采集的时间视频仍然是主要的可视化和引导模式， 全球每年进行超过1400万例手术，但它显示手术外科医生的器官 只有表面。腹腔镜超声可以显示内部结构，但通常显示在一个 单独的屏幕，让外科医生执行2种模态的心理整合。这个任务 效率低下，主观，和可变的专业知识。在手术区域中引入针， 消融手术由于需要记录多个、多个或多个区域， 用于理解三维空间关系和维护 手眼协调所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、 开发和临床翻译工作之前，这一拟议的项目已经证明， 所提出的AR可视化和导航的技术可行性和临床实用性。该团队已经 成功开发了研究原型，并在2岁时将最新原型用于11例人类病例 不同的手术中心这一建议是从我们的临床实践中得出的。 为建立临床系统提供翻译经验。主要的改善范围包括 降低了系统复杂性和尺寸，并提高了可靠性和临床可行性。儿童国家 医院和Terason将合作开发定制的专业腹腔镜超声 传感器，并提供AR作为商业超声上集成良好的高级应用程序 平台该项目的具体目标是：1）开发定制跟踪腹腔镜超声 换能器，2）开发具有集成跟踪和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价。我们的科学前提是 在手术中对正常和病理解剖结构进行全面的可视化， 消融针的引导将提高当前腹腔镜手术的精确性、安全性和效率， 并扩大其使用范围。拟议的学术-工业伙伴关系旨在 使得这些益处通过准备好用于常规使用的临床系统的开发来实现 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.