A partial augmented reality system with live ultrasound and registered preoperative MRI for guiding robot-assisted radical prostatectomy |
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| Institution: | 1. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;2. Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, Vancouver, BC V5Z 1M9, Canada;3. Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA;4. Surgical Intuitive, Sunnyvale, CA 94086, USA;5. Department of Radiology, University of British Columbia, Vancouver Hospital and Health Sciences Center, Vancouver, British Columbia, Canada;6. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada;1. Key Laboratory of Intelligent Computing and Signal Processing of Ministry of Education, Anhui University, China;2. School of Computer Science and Technology, Anhui University, China;3. Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Anhui, China;4. School of Health Science, Western University, London, ON N6A 3K7, Canada;5. Department of Medical Imaging, Western University, London, ON N6A 3K7, Canada;1. ViRVIG Group, UPC-BarcelonaTech, Llorens i Artigas, 4–6, Barcelona 08028, Spain;2. Digestive Department, Hospital General de Catalunya, Pedro i Pons 1, Sant Cugat del Vallès 08190, Spain;3. Digestive System Research Unit, University Hospital Vall d’Hebron, Passeig de la Vall d’Hebron 119–129, Barcelona 08035, Spain |
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| Abstract: | We propose an image guidance system for robot assisted laparoscopic radical prostatectomy (RALRP). A virtual 3D reconstruction of the surgery scene is displayed underneath the endoscope’s feed on the surgeon’s console. This scene consists of an annotated preoperative Magnetic Resonance Image (MRI) registered to intraoperative 3D Trans-rectal Ultrasound (TRUS) as well as real-time sagittal 2D TRUS images of the prostate, 3D models of the prostate, the surgical instrument and the TRUS transducer. We display these components with accurate real-time coordinates with respect to the robot system. Since the scene is rendered from the viewpoint of the endoscope, given correct parameters of the camera, an augmented scene can be overlaid on the video output. The surgeon can rotate the ultrasound transducer and determine the position of the projected axial plane in the MRI using one of the registered da Vinci instruments. This system was tested in the laboratory on custom-made agar prostate phantoms. We achieved an average total registration accuracy of 3.2 ± 1.3 mm. We also report on the successful application of this system in the operating room in 12 patients. The average registration error between the TRUS and the da Vinci system for the last 8 patients was 1.4 ± 0.3 mm and average target registration error of 2.1 ± 0.8 mm, resulting in an in vivo overall robot system to MRI mean registration error of 3.5 mm or less, which is consistent with our laboratory studies. |
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