Purpose

Resection site repair during laparoscopic oncological surgery (e.g. laparoscopic partial nephrectomy) poses some unique challenges and opportunities for augmented reality (AR) navigation support. This work introduces an AR registration workflow that addresses the time pressure that is present during resection site repair.

Methods

We propose a two-step registration process: the AR content is registered as accurately as possible prior to the tumour resection (the primary registration). This accurate registration is used to apply artificial fiducials to the physical organ and the virtual model. After the resection, these fiducials can be used for rapid re-registration (the secondary registration). We tested this pipeline in a simulated-use study with \(N=18\) participants. We compared the registration accuracy and speed for our method and for landmark-based registration as a reference.

Results

Acquisition of and, thereby, registration with the artificial fiducials were significantly faster than the initial use of anatomical landmarks. Our method also had a trend to be more accurate in cases in which the primary registration was successful. The accuracy loss between the elaborate primary registration and the rapid secondary registration could be quantified with a mean target registration error increase of 2.35 mm.

Conclusion

This work introduces a registration pipeline for AR navigation support during laparoscopic resection site repair and provides a successful proof-of-concept evaluation thereof. Our results indicate that the concept is better suited than landmark-based registration during this phase, but further work is required to demonstrate clinical suitability and applicability.

中文翻译：

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用于肿瘤切除部位修复的腹腔镜增强现实配准

目的

腹腔镜肿瘤手术（例如腹腔镜肾部分切除术）期间的切除部位修复为增强现实 (AR) 导航支持带来了一些独特的挑战和机遇。这项工作引入了 AR 配准工作流程，可解决切除部位修复期间存在的时间压力。

方法

我们提出了一个两步注册过程：在肿瘤切除（主要注册）之前尽可能准确地注册 AR 内容。这种精确的配准用于将人工基准应用于物理器官和虚拟模型。切除后，这些基准点可用于快速重新配准（二次配准）。我们在\(N=18\) 名参与者的模拟使用研究中测试了这条管道。我们比较了我们的方法和基于地标的配准作为参考的配准精度和速度。

结果

与最初使用解剖标志相比，人工基准的获取和配准要快得多。在初次注册成功的情况下，我们的方法也有更准确的趋势。精细初级配准和快速次级配准之间的精度损失可以量化，平均目标配准误差增加 2.35 毫米。

结论

这项工作在腹腔镜切除部位修复过程中引入了 AR 导航支持的注册管道，并提供了成功的概念验证评估。我们的结果表明，在此阶段，该概念比基于地标的配准更适合，但需要进一步的工作来证明临床适用性和适用性。