Tang Rui, Ma Longfei, Li Ang, Yu Lihan, Rong Zhixia, Zhang Xinjing, Xiang Canhong, Liao Hongen, Dong Jiahong
1 Department of Hepatopancreatobiliary Surgery, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Beijing, China.
2 Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
Surg Innov. 2018 Oct;25(5):492-498. doi: 10.1177/1553350618781622. Epub 2018 Jun 18.
We applied augmented reality (AR) techniques to flexible choledochoscopy examinations.
Enhanced computed tomography data of a patient with intrahepatic and extrahepatic biliary duct dilatation were collected to generate a hollow, 3-dimensional (3D) model of the biliary tree by 3D printing. The 3D printed model was placed in an opaque box. An electromagnetic (EM) sensor was internally installed in the choledochoscope instrument channel for tracking its movements through the passages of the 3D printed model, and an AR navigation platform was built using image overlay display. The porta hepatis was used as the reference marker with rigid image registration. The trajectories of the choledochoscope and the EM sensor were observed and recorded using the operator interface of the choledochoscope.
Training choledochoscopy was performed on the 3D printed model. The choledochoscope was guided into the left and right hepatic ducts, the right anterior hepatic duct, the bile ducts of segment 8, the hepatic duct in subsegment 8, the right posterior hepatic duct, and the left and the right bile ducts of the caudate lobe. Although stability in tracking was less than ideal, the virtual choledochoscope images and EM sensor tracking were effective for navigation.
AR techniques can be used to assist navigation in choledochoscopy examinations in bile duct models. Further research is needed to determine its benefits in clinical settings.
我们将增强现实（AR）技术应用于软性胆管镜检查。
收集一名肝内和肝外胆管扩张患者的增强计算机断层扫描数据，通过3D打印生成胆管树的中空三维（3D）模型。将3D打印模型放置在一个不透明的盒子中。在胆管镜器械通道内安装一个电磁（EM）传感器，用于跟踪其在3D打印模型通道中的移动，并使用图像叠加显示构建一个AR导航平台。以肝门作为刚性图像配准的参考标记。使用胆管镜的操作界面观察并记录胆管镜和EM传感器的轨迹。
在3D打印模型上进行了胆管镜训练。胆管镜被引导进入左右肝管、右前肝管、8段胆管、8段亚段肝管、右后肝管以及尾状叶左右胆管。尽管跟踪稳定性不太理想，但虚拟胆管镜图像和EM传感器跟踪对导航有效。
AR技术可用于辅助胆管镜检查在胆管模型中的导航。需要进一步研究以确定其在临床环境中的益处。
