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

Hannes G. Kenngott; Martin Wagner; Matthias Gondan; Felix Nickel; Marco Nolden; Andreas Fetzer; Jürgen Weitz; Lars Fischer; Stefanie Speidel; Hans-Peter Meinzer; Dittmar Böckler; Markus W. Büchler; Beat P. Müller-Stich

doi:10.1007/s00464-013-3249-0

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

Hannes G. Kenngott, Martin Wagner, Matthias Gondan, Felix Nickel, Marco Nolden, Andreas Fetzer, Jürgen Weitz, Lars Fischer, Stefanie Speidel, Hans-Peter Meinzer, Dittmar Böckler, Markus W. Büchler, Beat P. Müller-Stich

65 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Surgical Endoscopy
Volume	28
Issue number	3
Pages (from-to)	933-940
Number of pages	8
ISSN	0930-2794
DOIs	https://doi.org/10.1007/s00464-013-3249-0
Publication status	Published - Mar 2014

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Kenngott, H. G., Wagner, M., Gondan, M., Nickel, F., Nolden, M., Fetzer, A., Weitz, J., Fischer, L., Speidel, S., Meinzer, H-P., Böckler, D., Büchler, M. W., & Müller-Stich, B. P. (2014). Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging. Surgical Endoscopy, 28(3), 933-940. https://doi.org/10.1007/s00464-013-3249-0

Kenngott, HG, Wagner, M, Gondan, M, Nickel, F, Nolden, M, Fetzer, A, Weitz, J, Fischer, L, Speidel, S, Meinzer, H-P, Böckler, D, Büchler, MW & Müller-Stich, BP 2014, 'Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging', Surgical Endoscopy, vol. 28, no. 3, pp. 933-940. https://doi.org/10.1007/s00464-013-3249-0

@article{012b927ebc734de8af69edecf78b109d,

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

abstract = "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{\textregistered} 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.",

author = "Kenngott, {Hannes G.} and Martin Wagner and Matthias Gondan and Felix Nickel and Marco Nolden and Andreas Fetzer and J{\"u}rgen Weitz and Lars Fischer and Stefanie Speidel and Hans-Peter Meinzer and Dittmar B{\"o}ckler and B{\"u}chler, {Markus W.} and M{\"u}ller-Stich, {Beat P.}",

year = "2014",

month = mar,

doi = "10.1007/s00464-013-3249-0",

language = "English",

volume = "28",

pages = "933--940",

journal = "Surgical Endoscopy and Other Interventional Techniques",

issn = "0930-2794",

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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 and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

IS - 3

ER -

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

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