A case series study of augmented reality in laparoscopic liver resection with a deformable preoperative model
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and Other Interventional Techniques
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A case series study of augmented reality in laparoscopic liver resection with a deformable preoperative model Le Roy Bertrand1,2,4 · Mourad Abdallah1,2 · Yamid Espinel1 · Lilian Calvet1 · Bruno Pereira3 · Erol Ozgur1 · Denis Pezet1,2 · Emmanuel Buc1,2 · Adrien Bartoli1 Received: 13 April 2020 / Accepted: 10 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Previous work in augmented reality (AR) guidance in monocular laparoscopic hepatectomy requires the surgeon to manually overlay a rigid preoperative model onto a laparoscopy image. This may be fairly inaccurate because of significant liver deformation. We have proposed a technique which overlays a deformable preoperative model semi-automatically onto a laparoscopic image using a new software called Hepataug. The aim of this study is to show the feasibility of Hepataug to perform AR with a deformable model in laparoscopic hepatectomy. Methods We ran Hepataug during the procedures, as well as the usual means of laparoscopic ultrasonography (LUS) and visual inspection of the preoperative CT or MRI. The primary objective was to assess the feasibility of Hepataug, in terms of minimal disruption of the surgical workflow. The secondary objective was to assess the potential benefit of Hepataug, by subjective comparison with LUS. Results From July 2017 to March 2019, 17 consecutive patients were included in this study. AR was feasible in all procedures, with good correlation with LUS. However, for 2 patients, LUS did not reveal the location of the tumors. Hepataug gave a prediction of the tumor locations, which was confirmed and refined by careful inspection of the preoperative CT or MRI. Conclusion Hepataug showed a minimal disruption of the surgical workflow and can thus be feasibly used in real hepatectomy procedures. Thanks to its new mechanism of semi-automatic deformable alignment, Hepataug also showed a good agreement with LUS and visual CT or MRI inspection in subsurface tumor localization. Importantly, Hepataug yields reproducible results. It is easy to use and could be deployed in any existing operating room. Nevertheless, comparative prospective studies are needed to study its efficacy. Keywords Laparoscopy · Liver · Resection · Augmented reality · Deformable 3D model · Overlay
* Le Roy Bertrand [email protected] 1
UMR6602, Endoscopy and Computer Vision Group, Faculté de Médecine, Institut Pascal, Bâtiment 3C, 28 place Henri Dunant, 63000 Clermont‑Ferrand, France
2
Department of Digestive and Hepatobiliary Surgery, Hospital Estaing, CHU de Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003 Clermont‑Ferrand, France
3
Délégation à la Recherche Clinique et à l’innovation, Hopital Gabriel Montpied, CHU de Clermont-Ferrand, Place Henri Dunand, 63000 Clermont‑Ferrand, France
4
Department of Digestive and Oncologic Surgery, Hospital Nord, CHU de Saint-Etienne, Avenue Albert Raymond, 42270 Saint‑Priest‑en‑Jarez, France
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