Progressive internal landmark registration for surgical navigation in laparoscopic gastrectomy for gastric cancer

PurposeA surgical navigation system supports the comprehension of anatomical information during surgery. Patient-to-image registration is the alignment process between CT volume and patient coordinate systems. Achieving accurate registration in the surgical navigation of laparoscopic surgery is very challenging due to soft tissue deformation. This paper presents a new patient-to-image registration method based on internal anatomical landmarks for improving registration accuracy in the surgical navigation of laparoscopic gastrectomy for gastric cancer.MethodsOur proposed registration method progressively utilizes internal anatomical landmarks. In laparoscopic gastrectomy for gastric cancer, the surgeon cuts the blood vessels around the stomach. The positions of the cut vessels are sequentially used as fiducials for registration during surgery. The proposed method uses a weighted point-based registration method for computing the transformation matrix using the fiducials both on the body surface and on the blood vessels. When a blood vessel is cut during surgery, the proposed progressive registration method measures the cut vessel’s position and computes a transformation matrix by adding the cut vessel as a fiducial.ResultsWe applied our proposed progressive registration method using the positional information of the blood vessels acquired during laparoscopic gastrectomy in 20 cases. We evaluated it using target registration error in four blood vessels. The average target registration error in the four blood vessels was 12.6 mm and ranged from 2.1 to 32.9 mm.ConclusionSince the proposed progressive registration can reduce registration error, our proposed method is very useful for the surgical navigation of laparoscopic gastrectomy. Our proposed progressive registration method might increase the accuracy of surgical navigation in laparoscopic gastrectomy.

[1]  Y. Kodera,et al.  Longterm outcomes of early-stage gastric carcinoma patients treated with laparoscopy-assisted surgery. , 2008, Journal of the American College of Surgeons.

[2]  Makoto Hashizume,et al.  A real-time navigation system for laparoscopic surgery based on three-dimensional ultrasound using magneto-optic hybrid tracking configuration , 2007, International Journal of Computer Assisted Radiology and Surgery.

[3]  Makoto Hashizume,et al.  Image-guided laparoscopic surgery in an open MRI operating theater , 2013, Surgical Endoscopy.

[4]  Josien P. W. Pluim,et al.  Image Registration , 2003, IEEE Trans. Medical Imaging.

[5]  Sébastien Ourselin,et al.  Accuracy validation of an image guided laparoscopy system for liver resection , 2015, Medical Imaging.

[6]  K Sugimachi,et al.  Laparoscopy-assisted Billroth I gastrectomy. , 1994, Surgical laparoscopy & endoscopy.

[7]  J. Fitzpatrick,et al.  Medical image processing and analysis , 2000 .

[8]  Nassir Navab,et al.  Intraoperative Laparoscope Augmentation for Port Placement and Resection Planning in Minimally Invasive Liver Resection , 2008, IEEE Transactions on Medical Imaging.

[9]  Makoto Hashizume,et al.  Augmented reality navigation system for laparoscopic splenectomy in children based on preoperative CT image using optical tracking device , 2012, Pediatric Surgery International.

[10]  Hirotoshi Kikuchi,et al.  Usefulness of three-dimensional angiographic analysis of perigastric vessels before laparoscopic gastrectomy , 2013, Gastric Cancer.

[11]  Shuji Takiguchi,et al.  Laparoscopic intraoperative navigation surgery for gastric cancer using real-time rendered 3D CT images , 2015, Surgery Today.

[12]  Ali Serdar Gözen,et al.  Augmented reality: a new tool to improve surgical accuracy during laparoscopic partial nephrectomy? Preliminary in vitro and in vivo results. , 2009, European urology.

[13]  Kuang-Ching Wang,et al.  Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling , 2016 .

[14]  Junji Okuda,et al.  Preoperative simulation of vascular anatomy by three-dimensional computed tomography imaging in laparoscopic gastric cancer surgery. , 2003, Journal of the American College of Surgeons.

[15]  J. Marescaux,et al.  Augmented reality in laparoscopic surgical oncology. , 2011, Surgical oncology.

[16]  Masafumi Inomata,et al.  Minimally invasive approaches for gastric cancer—Japanese experiences , 2013, Journal of surgical oncology.

[17]  David J. Hawkes,et al.  Clinical application of a surgical navigation system based on virtual laparoscopy in laparoscopic gastrectomy for gastric cancer , 2016, International Journal of Computer Assisted Radiology and Surgery.

[18]  J. Marescaux,et al.  Augmented-reality-assisted laparoscopic adrenalectomy. , 2004, JAMA.

[19]  Jay B. West,et al.  Predicting error in rigid-body point-based registration , 1998, IEEE Transactions on Medical Imaging.

[20]  Kensaku Mori,et al.  Method of interactive specification of interested regions via a volume-rendered image with application to virtualized endoscope system , 2000, Medical Imaging.

[21]  J. Kaspersen,et al.  Laparoscopic navigation pointer for three-dimensional image–guided surgery , 2004, Surgical Endoscopy And Other Interventional Techniques.