Acar Ayberk, Lu Daiwei, Wu Yifan, Oguz Ipek, Kavoussi Nicholas, Wu Jie Ying
Department of Computer Science Vanderbilt University Nashville Tennessee USA.
Present address: Department of Computer Science Vanderbilt University Nashville Tennessee USA.
Healthc Technol Lett. 2023 Dec 13;11(2-3):67-75. doi: 10.1049/htl2.12059. eCollection 2024 Apr-Jun.
Endoscopic renal surgeries have high re-operation rates, particularly for lower volume surgeons. Due to the limited field and depth of view of current endoscopes, mentally mapping preoperative computed tomography (CT) images of patient anatomy to the surgical field is challenging. The inability to completely navigate the intrarenal collecting system leads to missed kidney stones and tumors, subsequently raising recurrence rates. A guidance system is proposed to estimate the endoscope positions within the CT to reduce re-operation rates. A Structure from Motion algorithm is used to reconstruct the kidney collecting system from the endoscope videos. In addition, the kidney collecting system is segmented from CT scans using 3D U-Net to create a 3D model. The two collecting system representations can then be registered to provide information on the relative endoscope position. Correct reconstruction and localization of intrarenal anatomy and endoscope position is demonstrated. Furthermore, a 3D map is created supported by the RGB endoscope images to reduce the burden of mental mapping during surgery. The proposed reconstruction pipeline has been validated for guidance. It can reduce the mental burden for surgeons and is a step towards the long-term goal of reducing re-operation rates in kidney stone surgery.
内镜肾脏手术的再次手术率很高，尤其是对于手术量较少的外科医生而言。由于当前内窥镜的视野范围和深度有限，在脑海中将患者解剖结构的术前计算机断层扫描（CT）图像映射到手术视野具有挑战性。无法完全在内肾集合系统中导航会导致肾结石和肿瘤遗漏，进而提高复发率。为了降低再次手术率，提出了一种用于估计内窥镜在CT中的位置的引导系统。使用运动结构算法从内窥镜视频重建肾脏集合系统。此外，使用3D U-Net从CT扫描中分割出肾脏集合系统以创建3D模型。然后可以将这两种集合系统表示进行配准，以提供有关内窥镜相对位置的信息。展示了肾内解剖结构和内窥镜位置的正确重建与定位。此外，由RGB内窥镜图像支持创建3D地图，以减轻手术过程中的脑海映射负担。所提出的重建流程已通过验证用于引导。它可以减轻外科医生的心理负担，是朝着降低肾结石手术再次手术率的长期目标迈出的一步。
