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增强现实技术在腹部手术导航中的临床应用。

Clinical application of navigation surgery using augmented reality in the abdominal field.

作者信息

Okamoto Tomoyoshi, Onda Shinji, Yanaga Katsuhiko, Suzuki Naoki, Hattori Asaki

机构信息

Department of Surgery, The Jikei University Daisan Hospital, 4-11-1 Izumihoncho, Komae-shi, Tokyo, Japan,

出版信息

Surg Today. 2015 Apr;45(4):397-406. doi: 10.1007/s00595-014-0946-9. Epub 2014 Jun 6.

Abstract

This article presents general principles and recent advancements in the clinical application of augmented reality-based navigation surgery (AR based NS) for abdominal procedures and includes a description of our clinical trial and subsequent outcomes. Moreover, current problems and future aspects are discussed. The development of AR-based NS in the abdomen is delayed compared with another field because of the problem of intraoperative organ deformations or the existence of established modalities. Although there are a few reports on the clinical use of AR-based NS for digestive surgery, sophisticated technologies in urology have often been reported. However, the rapid widespread use of video- or robot assisted surgeries requires this technology. We have worked to develop a system of AR-based NS for hepatobiliary and pancreatic surgery. Then we developed a short rigid scope that enables surgeons to obtain 3D view. We recently focused on pancreatic surgery, because intraoperative organ shifting is minimal. The position of each organ in overlaid image almost corresponded with that of the actual organ with about 5 mm of mean registration errors. Intraoperative information generated from this system provided us with useful navigation. However, AR-based NS has several problems to overcome such as organ deformity, evaluation of utility, portability or cost.

摘要

本文介绍了基于增强现实的导航手术(AR 导航手术)在腹部手术临床应用中的一般原则和最新进展,包括我们的临床试验及后续结果的描述。此外,还讨论了当前存在的问题和未来的发展方向。由于术中器官变形问题或已有成熟手术方式的存在,腹部 AR 导航手术的发展相较于其他领域有所滞后。尽管有一些关于 AR 导航手术在消化外科临床应用的报道,但泌尿外科的先进技术报道更为常见。然而,视频辅助或机器人辅助手术的迅速普及需要这项技术。我们致力于开发用于肝胆胰手术的 AR 导航手术系统。随后,我们开发了一种短刚性内窥镜,使外科医生能够获得三维视野。我们最近将重点放在胰腺手术上,因为术中器官移位最小。叠加图像中每个器官的位置与实际器官的位置几乎相符,平均配准误差约为 5 毫米。该系统生成的术中信息为我们提供了有用的导航。然而,AR 导航手术仍有几个问题需要克服,如器官变形、实用性评估、便携性或成本等。

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