Abstract：
BACKGROUND:Although systems of 3-dimensional image-guided surgery are a valuable adjunct across numerous procedures, differences in organ shape between that reflected in the preoperative image data and the intraoperative state can compromise the fidelity of such guidance based on the image. In this work, we assessed in real time a novel, 3-dimensional image-guided operation platform that incorporates soft tissue deformation. METHODS:A series of 125 alignment evaluations were performed across 20 patients. During the operation, the surgeon assessed the liver by swabbing an optically tracked stylus over the liver surface and viewing the image-guided operation display. Each patient had approximately 6 intraoperative comparative evaluations. For each assessment, 1 of only 2 types of alignments were considered: conventional rigid and novel deformable. The series of alignment types used was randomized and blinded to the surgeon. The surgeon provided a rating, R, from -3 to +3 for each display compared with the previous display, whereby a negative rating indicated degradation in fidelity and a positive rating an improvement. RESULTS:A statistical analysis of the series of rating data by the clinician indicated that the surgeons were able to perceive an improvement (defined as a R > 1) of the model-based registration over the rigid registration (P = .01) as well as a degradation (defined as R < -1) when the rigid registration was compared with the novel deformable guidance information (P = .03). CONCLUSION:This study provides evidence of the benefit of deformation correction in providing an accurate location for the liver for use in image-guided surgery systems.
journal_name
Surgeryjournal_title
Surgeryauthors
Clements LW,Collins JA,Weis JA,Simpson AL,Kingham TP,Jarnagin WR,Miga MIdoi
10.1016/j.surg.2017.04.020subject
Has Abstractpub_date
2017-09-01 00:00:00pages
537-547issue
3eissn
0039-6060issn
1532-7361pii
S0039-6060(17)30327-6journal_volume
162pub_type
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