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Proceedings Paper

Emulation of the laparoscopic environment for image-guided liver surgery via an abdominal phantom system with anatomical ligamenture
Author(s): Jon S. Heiselman; Jarrod A. Collins; Logan W. Clements; Jared A. Weis; Amber L. Simpson; Sunil K. Geevarghese; William R. Jarnagin; Michael I. Miga
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Paper Abstract

In order to rigorously validate techniques for image-guided liver surgery (IGLS), an accurate mock representation of the intraoperative surgical scene with quantifiable localization of subsurface targets would be highly desirable. However, many attempts to reproduce the laparoscopic environment have encountered limited success due to neglect of several crucial design aspects. The laparoscopic setting is complicated by factors such as gas insufflation of the abdomen, changes in patient orientation, incomplete organ mobilization from ligaments, and limited access to organ surface data. The ability to accurately represent the influences of anatomical changes and procedural limitations is critical for appropriate evaluation of IGLS methodologies such as registration and deformation correction. However, these influences have not yet been comprehensively integrated into a platform usable for assessment of methods in laparoscopic IGLS. In this work, a mock laparoscopic liver simulator was created with realistic ligamenture to emulate the complexities of this constrained surgical environment for the realization of laparoscopic IGLS. The mock surgical system reproduces an insufflated abdominal cavity with dissectible ligaments, variable levels of incline matching intraoperative patient positioning, and port locations in accordance with surgical protocol. True positions of targets embedded in a tissue-mimicking phantom are measured from CT images. Using this setup, image-to-physical registration accuracy was evaluated for simulations of laparoscopic right and left lobe mobilization to assess rigid registration performance under more realistic laparoscopic conditions. Preliminary results suggest that non-rigid organ deformations and the region of organ surface data collected affect the ability to attain highly accurate registrations in laparoscopic applications.

Paper Details

Date Published: 3 March 2017
PDF: 9 pages
Proc. SPIE 10135, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling, 101352W (3 March 2017); doi: 10.1117/12.2255842
Show Author Affiliations
Jon S. Heiselman, Vanderbilt Univ. (United States)
Jarrod A. Collins, Vanderbilt Univ. (United States)
Logan W. Clements, Vanderbilt Univ. (United States)
Jared A. Weis, Vanderbilt Univ. (United States)
Amber L. Simpson, Memorial Sloan-Kettering Cancer Ctr. (United States)
Sunil K. Geevarghese, Vanderbilt Univ. Medical Ctr. (United States)
William R. Jarnagin, Memorial Sloan-Kettering Cancer Ctr. (United States)
Michael I. Miga, Vanderbilt Univ. (United States)
Vanderbilt Univ. Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 10135:
Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling
Robert J. Webster III; Baowei Fei, Editor(s)

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