Research on registration and navigation technology of augmented reality for ex-vivo hepatectomy

Int J Comput Assist Radiol Surg. 2022 Jan;17(1):147-155. doi: 10.1007/s11548-021-02531-w. Epub 2021 Nov 20.

Abstract

Purpose: The application of augmented reality technology to the partial hepatectomy procedure has high practical significance, but the existing augmented reality navigation system has major drawbacks in the display and registration methods, which result in low precision. The augmented reality surgical navigation system proposed in this study has been improved in the above two aspects, which can significantly improve the surgical accuracy.

Methods: The use of optical see-through head-mounted displays for imaging displays can prevent doctors from reconstructing the patient's two-dimensional image information in their minds and reduce the psychological burden of doctors. In the registration process, the biomechanical properties of the liver are introduced, and a non-rigid registration method based on biomechanics is proposed and realized by a meshless algorithm. In addition, this study uses the moving grid algorithm to carry out clinical experiments on ex-vivo pig liver for experimental verification.

Results: The mark-based interactive registration error is 4.21 ± 1.6 mm, and the registration error is reduced after taking the biomechanical properties of the liver into account, which is - 0.153 ± 0.398 mm. The cutting error of the liver model is 0.159 ± 0.292 mm. In addition, with the aid of the navigation system proposed in this paper, the experiment of ex-vivo pig liver cutting was completed with an error of - 1.164 ± 0.576 mm.

Conclusions: As a proof-of-concept study, the augmented reality navigation system proposed in this study improves the traditional image-guided surgery in terms of display and registration methods, and the feasibility of the system is verified by ex-vivo pig liver experiments. Therefore, the navigation system has a certain guiding significance for clinical surgery.

Keywords: Augmented reality; Biomechanical property; Non-rigid registration; Optical see-through head-mounted displays; Partial hepatectomy.

MeSH terms

  • Algorithms
  • Animals
  • Augmented Reality*
  • Hepatectomy
  • Imaging, Three-Dimensional
  • Surgery, Computer-Assisted*
  • Swine
  • Technology