Mårvik R, Langø T, Tangen G A, Lindseth F, Yavuz Y, Nagelhus Hernes T A
National Centre for Advanced Laparoscopic Surgery, Deptartment of Surgery, St. Olav's Hospital, Trondheim, Norway.
Minerva Chir. 2005 Oct;60(5):305-25.
The main drawback with laparoscopic surgery is that the surgeon is unable to palpate vessels, tumours and organs during surgery. Further-more, the laparoscope only provides a surface view of organs. There is a need for more advanced visualizations techniques that can enhance the display presented to the surgeon so that important information below the surface of the organs is included when planning the procedure as well as for guidance and control during treatment. In this paper, we present a review of the literature and the state of art within image-guided laparoscopic surgery. We describe our own experience using a prototype navigation system for advanced visualizations and guidance during laparoscopic procedures in the retroperitoneum. Furthermore, we show sample images from the Future Operating Room for laparoscopic surgery in Trondheim, where this technology is being further developed and tested in clinical studies. Our system is based on three-dimensional navigation technology, i.e. preoperatively acquired magnetic resonance or computed tomography data used in combination with tracked instruments, allowing the surgeon to interactively control the display of images prior to and during surgery with normal use of the instruments. In summary, we believe that abdominal image navigation using tracked instruments and advanced visualizations has a large potential for improving future laparoscopic surgery, especially in cases where vessels and anatomical relations beyond surfaces is difficult to identify using only a laparoscope. The technology helps the surgeon to better understand the anatomy and locate blood vessels. Accordingly, we believe that this new technology could increase safety and make it easier for the surgeon to perform successful laparoscopic surgery.
腹腔镜手术的主要缺点是，外科医生在手术过程中无法触摸血管、肿瘤和器官。此外，腹腔镜仅能提供器官的表面视图。需要更先进的可视化技术，以增强呈现给外科医生的显示效果，以便在规划手术过程时纳入器官表面以下的重要信息，并在治疗过程中用于引导和控制。在本文中，我们对图像引导腹腔镜手术的文献和技术现状进行了综述。我们描述了在腹膜后腹腔镜手术过程中，使用先进可视化和引导的原型导航系统的自身经验。此外，我们展示了来自特隆赫姆未来手术室的腹腔镜手术样本图像，该技术正在那里的临床研究中进一步开发和测试。我们的系统基于三维导航技术，即术前获取的磁共振或计算机断层扫描数据与跟踪仪器相结合，使外科医生在手术前和手术过程中正常使用仪器时能够交互式地控制图像显示。总之，我们认为，使用跟踪仪器和先进可视化技术的腹部图像导航在改善未来腹腔镜手术方面具有巨大潜力，尤其是在仅使用腹腔镜难以识别表面以外的血管和解剖关系的情况下。该技术有助于外科医生更好地了解解剖结构并定位血管。因此，我们相信这项新技术可以提高安全性，并使外科医生更容易成功地进行腹腔镜手术。
