Surgical Endoscopy

, Volume 28, Issue 5, pp 1734–1741 | Cite as

Ultrasound-based tumor movement compensation during navigated laparoscopic liver interventions

  • Osama Shahin
  • Armin Beširević
  • Markus Kleemann
  • Alexander Schlaefer
New Technology

Abstract

Background

Image-guided navigation aims to provide better orientation and accuracy in laparoscopic interventions. However, the ability of the navigation system to reflect anatomical changes and maintain high accuracy during the procedure is crucial. This is particularly challenging in soft organs such as the liver, where surgical manipulation causes significant tumor movements. We propose a fast approach to obtain an accurate estimation of the tumor position throughout the procedure.

Methods

Initially, a three-dimensional (3D) ultrasound image is reconstructed and the tumor is segmented. During surgery, the position of the tumor is updated based on newly acquired tracked ultrasound images. The initial segmentation of the tumor is used to automatically detect the tumor and update its position in the navigation system. Two experiments were conducted. First, a controlled phantom motion using a robot was performed to validate the tracking accuracy. Second, a needle navigation scenario based on pseudotumors injected into ex vivo porcine liver was studied.

Result

In the robot-based evaluation, the approach estimated the target location with an accuracy of 0.4 ± 0.3 mm. The mean navigation error in the needle experiment was 1.2 ± 0.6 mm, and the algorithm compensated for tumor shifts up to 38 mm in an average time of 1 s.

Conclusion

We demonstrated a navigation approach based on tracked laparoscopic ultrasound (LUS), and focused on the neighborhood of the tumor. Our experimental results indicate that this approach can be used to quickly and accurately compensate for tumor movements caused by surgical manipulation during laparoscopic interventions. The proposed approach has the advantage of being based on the routinely used LUS; however, it upgrades its functionality to estimate the tumor position in 3D. Hence, the approach is repeatable throughout surgery, and enables high navigation accuracy to be maintained.

Keywords

Liver Tumor shift Intraoperative ultrasound Tracking Navigation 

Notes

Acknowledgments

This work was supported by the Graduate School for Computing in Medicine and Life Sciences funded by Germany’s Excellence Initiative (DFG GSC 235/1).

Disclosures

Osama Shahin, Armin Beširević, Markus Kleemann, and Alexander Schlaefer have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Osama Shahin
    • 1
    • 2
  • Armin Beširević
    • 3
  • Markus Kleemann
    • 3
  • Alexander Schlaefer
    • 1
    • 2
  1. 1.Medical Robotics, Institute for Robotics and Cognitive SystemsUniversity of LübeckLübeckGermany
  2. 2.Graduate School for Computing in Medicine and Life SciencesUniversity of LübeckLübeckGermany
  3. 3.Department of SurgeryUniversity Hospital Schleswig-HolsteinLübeckGermany

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