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01-10-2020 | Liver Surgery | Original Article

Efficiency, Accuracy and Clinical Applicability of a New Image-Guided Surgery System in 3D Laparoscopic Liver Surgery

Authors: Gian Andrea Prevost, Benjamin Eigl, Iwan Paolucci, Tobias Rudolph, Matthias Peterhans, Stefan Weber, Guido Beldi, Daniel Candinas, Anja Lachenmayer

Published in: Journal of Gastrointestinal Surgery | Issue 10/2020

Abstract

Background

To investigate efficiency, accuracy and clinical benefit of a new augmented reality system for 3D laparoscopic liver surgery.

Methods

All patients who received laparoscopic liver resection by a new image-guided surgery system with augmented 3D-imaging in a university hospital were included for analysis. Digitally processed preoperative cross-sectional imaging was merged with the laparoscopic image. Intraoperative efficiency of the procedure was measured as time needed to achieve sufficient registration accuracy. Technical accuracy was reported as fiducial registration error (FRE). Clinical benefit was assessed trough a questionnaire, reporting measures in a 5-point Likert scale format ranging from 1 (high) to 5 (low).

Results

From January to March 2018, ten laparoscopic liver resections of a total of 18 lesions were performed using the novel augmented reality system. Median time for registration was 8:50 min (range 1:31–23:56). The mean FRE was reduced from 14.0 mm (SD 5.0) in the first registration attempt to 9.2 mm (SD 2.8) in the last attempt. The questionnaire revealed the ease of use of the system (1.2, SD 0.4) and the benefit for resection of vanishing lesions (1.0, SD 0.0) as convincing positive aspects, whereas image registration accuracy for resection guidance was consistently judged as too inaccurate.

Conclusions

Augmented reality in 3D laparoscopic liver surgery with landmark-based registration technique is feasible with only little impact on the intraoperative workflow. The benefit for detecting particularly vanishing lesions is high. For an additional benefit during the resection process, registration accuracy has to be improved and non-rigid registration algorithms will be required to address intraoperative anatomical deformation.

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Title: Efficiency, Accuracy and Clinical Applicability of a New Image-Guided Surgery System in 3D Laparoscopic Liver Surgery
Authors: Gian Andrea Prevost
Benjamin Eigl
Iwan Paolucci
Tobias Rudolph
Matthias Peterhans
Stefan Weber
Guido Beldi
Daniel Candinas
Anja Lachenmayer
Publication date: 01-10-2020
Publisher: Springer US
Keywords: Liver Surgery
Liver Surgery
Published in: Journal of Gastrointestinal Surgery / Issue 10/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04395-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficiency, Accuracy and Clinical Applicability of a New Image-Guided Surgery System in 3D Laparoscopic Liver Surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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