1 Department of Psychology, Faculty of Social Sciences, Københavns Universitet2 unknown3 Institut for Psykologi, Department of Psychology, Faculty of Social Sciences, Københavns Universitet4 Institut for Psykologi, Department of Psychology, Faculty of Social Sciences, Københavns Universitet
first clinical experience with a guidance system based on intraoperative CT imaging
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 sixteen 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 mm ± 0.52 mm with a maximum error of 2.49 mm. The patient successfully underwent the operation and showed no post-operative 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.
Surgical Endoscopy, 2014, Vol 28, Issue 3, p. 933-940