Single feature constrained manual registration method for Augmented Reality applications in gynecological laparoscopic interventions.

Augmented Reality (AR) can avoid some of the drawbacks of Minimally Invasive Surgery and may provide opportunities for developing innovative tools to assist surgeons. In laparoscopic surgery, the achievement of easy and sufficiently accurate registration is an open challenge. This is particularly true in procedures, such as laparoscopic abdominal Sacro-Colpopexy, where there is a lack of a sufficient number of visible anatomical landmarks to be used as a reference for registration. In an attempt to address the above limitations, we developed and preliminarily testes a constrained manual procedure based on the identification of a single anatomical landmark in the laparoscopic images, and the intraoperative measurement of the laparoscope orientation. Tests in a rigid in-vitro environment show good accuracy (median error 2.4 mm obtained in about 4 min) and good preliminary feedback from the technical staff who tested the system. Further experimentation in a more realistic environment is needed to validate these positive results. Clinical Relevance - This paper provides a new registration method for the development of AR educational videos and AR-based navigation systems for laparoscopic interventions.