SmartLiver Image Guidance System for Laparoscopic Liver Resection

Minimally invasive surgery, both robotic and laparoscopic, has demonstrable benefits for the patient. However, inability to distinguish different tissues and target lesions reduces eligibity for laparoscopic surgery. Image guidance using previously acquired imaging has the potential to mitigate these effects increasing eligibity for minimally invasive surgery. We present the ''SmartLiver'' image guidance system for image guided laparoscopic and robotic liver resection. Existing image guidance systems for the liver [2,3] rely on separate probes to locate points on the liver surface relative to the theatre coordinate system. With sufficiently long digitizing probes these systems can be used for laparoscopic as well as open surgery. However, as well as requiring an additional tool in theatre they do not locate the laparoscope relative to the liver, precluding the use of augmented reality on the laparoscope's display. The SmartLiver guidance system addresses these two short comings by using a tracked stereo laparoscope to locate the liver surface. This paper describes the system, results of validation experiments on porcine and phantom models and initial results from first use in humans.