Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging

TY - JOUR

T1 - Real-time image guidance in laparoscopic liver surgery

T2 - first clinical experience with a guidance system based on intraoperative CT imaging

AU - Kenngott, Hannes G.

AU - Wagner, Martin

AU - Gondan, Matthias

AU - Nickel, Felix

AU - Nolden, Marco

AU - Fetzer, Andreas

AU - Weitz, Jürgen

AU - Fischer, Lars

AU - Speidel, Stefanie

AU - Meinzer, Hans-Peter

AU - Böckler, Dittmar

AU - Büchler, Markus W.

AU - Müller-Stich, Beat P.

PY - 2014/3

Y1 - 2014/3

N2 - Background: Laparoscopic liver surgery is particularly challenging owing to restricted access, risk of bleeding, and lack of haptic feedback. Navigation systems have the potential to improve information on the exact position of intrahepatic tumors, and thus facilitate oncological resection. This study aims to evaluate the feasibility of a commercially available augmented reality (AR) guidance system employing intraoperative robotic C-arm cone-beam computed tomography (CBCT) for laparoscopic liver surgery. Methods: A human liver-like phantom with 16 target fiducials was used to evaluate the Syngo iPilot® AR system. Subsequently, the system was used for the laparoscopic resection of a hepatocellular carcinoma in segment 7 of a 50-year-old male patient. Results: In the phantom experiment, the AR system showed a mean target registration error of 0.96 ± 0.52 mm, with a maximum error of 2.49 mm. The patient successfully underwent the operation and showed no postoperative complications. Conclusion: The use of intraoperative CBCT and AR for laparoscopic liver resection is feasible and could be considered an option for future liver surgery in complex cases.

AB - Background: Laparoscopic liver surgery is particularly challenging owing to restricted access, risk of bleeding, and lack of haptic feedback. Navigation systems have the potential to improve information on the exact position of intrahepatic tumors, and thus facilitate oncological resection. This study aims to evaluate the feasibility of a commercially available augmented reality (AR) guidance system employing intraoperative robotic C-arm cone-beam computed tomography (CBCT) for laparoscopic liver surgery. Methods: A human liver-like phantom with 16 target fiducials was used to evaluate the Syngo iPilot® AR system. Subsequently, the system was used for the laparoscopic resection of a hepatocellular carcinoma in segment 7 of a 50-year-old male patient. Results: In the phantom experiment, the AR system showed a mean target registration error of 0.96 ± 0.52 mm, with a maximum error of 2.49 mm. The patient successfully underwent the operation and showed no postoperative complications. Conclusion: The use of intraoperative CBCT and AR for laparoscopic liver resection is feasible and could be considered an option for future liver surgery in complex cases.

U2 - 10.1007/s00464-013-3249-0

DO - 10.1007/s00464-013-3249-0

M3 - Journal article

C2 - 24178862

SN - 0930-2794

VL - 28

SP - 933

EP - 940

JO - Surgical Endoscopy

JF - Surgical Endoscopy

IS - 3

ER -