Characterization and correction of intraoperative soft tissue deformation in image-guided laparoscopic liver surgery

Jon S. Heiselman; Logan W. Clements; Jarrod A. Collins; Jared A. Weis; Amber L. Simpson; Sunil K. Geevarghese M.D.; T. Peter Kingham M.D.; William R. Jarnagin M.D.; Michael I. Miga

doi:10.1117/1.JMI.5.2.021203

14 December 2017 Characterization and correction of intraoperative soft tissue deformation in image-guided laparoscopic liver surgery

Jon S. Heiselman, Logan W. Clements, Jarrod A. Collins, Jared A. Weis, Amber L. Simpson, Sunil K. Geevarghese M.D., T. Peter Kingham M.D., William R. Jarnagin M.D., Michael I. Miga

Author Affiliations +

Journal of Medical Imaging, Vol. 5, Issue 2, 021203 (December 2017). https://doi.org/10.1117/1.JMI.5.2.021203

Abstract

Laparoscopic liver surgery is challenging to perform due to a compromised ability of the surgeon to localize subsurface anatomy in the constrained environment. While image guidance has the potential to address this barrier, intraoperative factors, such as insufflation and variable degrees of organ mobilization from supporting ligaments, may generate substantial deformation. The severity of laparoscopic deformation in humans has not been characterized, and current laparoscopic correction methods do not account for the mechanics of how intraoperative deformation is applied to the liver. We first measure the degree of laparoscopic deformation at two insufflation pressures over the course of laparoscopic-to-open conversion in 25 patients. With this clinical data alongside a mock laparoscopic phantom setup, we report a biomechanical correction approach that leverages anatomically load-bearing support surfaces from ligament attachments to iteratively reconstruct and account for intraoperative deformations. Laparoscopic deformations were significantly larger than deformations associated with open surgery, and our correction approach yielded subsurface target error of 6.7±1.3 mm and surface error of 0.8±0.4 mm using only sparse surface data with realistic surgical extent. Laparoscopic surface data extents were examined and found to impact registration accuracy. Finally, we demonstrate viability of the correction method with clinical data.

Citation Download Citation

Jon S. Heiselman, Logan W. Clements, Jarrod A. Collins, Jared A. Weis, Amber L. Simpson, Sunil K. Geevarghese M.D., T. Peter Kingham M.D., William R. Jarnagin M.D., and Michael I. Miga "Characterization and correction of intraoperative soft tissue deformation in image-guided laparoscopic liver surgery," Journal of Medical Imaging 5(2), 021203 (14 December 2017). https://doi.org/10.1117/1.JMI.5.2.021203

Received: 7 September 2017; Accepted: 21 November 2017; Published: 14 December 2017

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE

Includes PDF, HTML & Video, when available