Edgcumbe Philip, Singla Rohit, Pratt Philip, Schneider Caitlin, Nguan Christopher, Rohling Robert
University of British Columbia, MD/PhD Program, Vancouver, Canada.
University of British Columbia, Department of Electrical and Computer Engineering, Vancouver, Canada.
J Med Imaging (Bellingham). 2018 Apr;5(2):021216. doi: 10.1117/1.JMI.5.2.021216. Epub 2018 Feb 14.
A projector-based augmented reality intracorporeal system (PARIS) is presented that includes a miniature tracked projector, tracked marker, and laparoscopic ultrasound (LUS) transducer. PARIS was developed to improve the efficacy and safety of laparoscopic partial nephrectomy (LPN). In particular, it has been demonstrated to effectively assist in the identification of tumor boundaries during surgery and to improve the surgeon's understanding of the underlying anatomy. PARIS achieves this by displaying the orthographic projection of the cancerous tumor on the kidney's surface. The performance of PARIS was evaluated in a user study with two surgeons who performed 32 simulated robot-assisted partial nephrectomies. They performed 16 simulated partial nephrectomies with PARIS for guidance and 16 simulated partial nephrectomies with only an LUS transducer for guidance. With PARIS, there was a significant reduction [30% ([Formula: see text])] in the amount of healthy tissue excised and a trend toward a more accurate dissection around the tumor and more negative margins. The combined point tracking and reprojection root-mean-square error of PARIS was 0.8 mm. PARIS' proven ability to improve key metrics of LPN surgery and qualitative feedback from surgeons about PARIS supports the hypothesis that it is an effective surgical navigation tool.
本文介绍了一种基于投影仪的增强现实体内系统（PARIS），该系统包括一个微型跟踪投影仪、跟踪标记和腹腔镜超声（LUS）换能器。PARIS的开发旨在提高腹腔镜部分肾切除术（LPN）的疗效和安全性。特别是，已证明它能在手术期间有效协助识别肿瘤边界，并提高外科医生对潜在解剖结构的理解。PARIS通过在肾脏表面显示癌性肿瘤的正投影来实现这一点。在一项用户研究中，对两名外科医生进行了PARIS性能评估，他们进行了32次模拟机器人辅助部分肾切除术。他们在PARIS的引导下进行了16次模拟部分肾切除术，并在仅使用LUS换能器引导的情况下进行了16次模拟部分肾切除术。使用PARIS后，切除的健康组织量显著减少[30%（[公式：见原文]）]，并且在肿瘤周围进行更精确解剖和获得更多阴性切缘方面有趋势。PARIS的组合点跟踪和重投影均方根误差为0.8毫米。PARIS改善LPN手术关键指标的已证实能力以及外科医生对PARIS的定性反馈支持了它是一种有效手术导航工具的假设。
