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Erschienen in:
05.06.2020 | Original Article
Evaluation of a marker-less, intra-operative, augmented reality guidance system for robot-assisted laparoscopic radical prostatectomy
Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 7/2020
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Purpose
Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical robot is a common treatment for organ-confined prostate cancer. Augmented reality (AR) can help during RALRP by showing the surgeon the location of anatomical structures and tumors from preoperative imaging. Previously, we proposed hand-eye and camera intrinsic matrix estimation procedures that can be carried out with conventional instruments within the patient during surgery, take < 3 min to perform, and fit seamlessly in the existing surgical workflow. In this paper, we describe and evaluate a complete AR guidance system for RALRP and quantify its accuracy.
Methods
Our AR system requires three transformations: the transrectal ultrasound (TRUS) to da Vinci transformation, the camera intrinsic matrix, and the hand-eye transformation. For evaluation, a 3D-printed cross-wire was visualized in TRUS and stereo endoscope in a water bath. Manually triangulated cross-wire points from stereo images were used as ground truth to evaluate overall TRE between these points and points transformed from TRUS to camera.
Results
After transforming the ground-truth points from the TRUS to the camera coordinate frame, the mean target registration error (TRE) (SD) was \(4.56\pm 1.57\) mm. The mean TREs (SD) in the x-, y-, and z-directions are \(1.93\pm 1.26\) mm, \(2.04\pm 1.37\) mm, and \(2.94\pm 1.84\) mm, respectively.
Conclusions
We describe and evaluate a complete AR guidance system for RALRP which can augment preoperative data to endoscope camera image, after a deformable magnetic resonance image to TRUS registration step. The streamlined procedures with current surgical workflow and low TRE demonstrate the compatibility and readiness of the system for clinical translation. A detailed sensitivity study remains part of future work.