scholarly journals Surgical Navigation System for Transsphenoidal Pituitary Surgery Applying U-Net-Based Automatic Segmentation and Bendable Devices

2019 ◽  
Vol 9 (24) ◽  
pp. 5540
Author(s):  
Hwa-Seob Song ◽  
Hyun-Soo Yoon ◽  
Seongpung Lee ◽  
Chang-Ki Hong ◽  
Byung-Ju Yi
Keyword(s):  
Navigation System ◽  
Surgical Navigation ◽  
Automatic Segmentation ◽  
Pituitary Surgery ◽  
Organ Damage ◽  
Navigation Systems ◽  
Surgical Tools ◽  
Registration Errors ◽  
Surgical Tool ◽  
Transsphenoidal Pituitary Surgery

Conventional navigation systems used in transsphenoidal pituitary surgery have limitations that may lead to organ damage, including long image registration time, absence of alarms when approaching vital organs and lack of 3-D model information. To resolve the problems of conventional navigation systems, this study proposes a U-Net-based, automatic segmentation algorithm for optical nerves and internal carotid arteries, by training patient computed tomography angiography images. The authors have also developed a bendable endoscope and surgical tool to eliminate blind regions that occur when using straight, rigid, conventional endoscopes and surgical tools during transsphenoidal pituitary surgery. In this study, the effectiveness of a U-Net-based navigation system integrated with bendable surgical tools and a bendable endoscope has been demonstrated through phantom-based experiments. In order to measure the U-net performance, the Jaccard similarity, recall and precision were calculated. In addition, the fiducial and target registration errors of the navigation system and the accuracy of the alarm warning functions were measured in the phantom-based environment.

scholarly journals Skull Base Surgery Navigation System Based on Updating Preoperative Images Using Positional Information of Surgical Tools

2013 ◽  
Author(s):  
Yuichiro Hayashi ◽  
Masazumi Fujii ◽  
Yasukazu Kajita ◽  
Toshihiko Wakabayashi ◽  
Kensaku Mori
Keyword(s):  
Skull Base ◽  
Navigation System ◽  
Bone Structure ◽  
Surgical Navigation ◽  
Skull Base Surgery ◽  
Positional Information ◽  
Navigation Systems ◽  
Surgical Tools ◽  
Bone Removal ◽  
Reference Images

In this paper, we introduce a new concept of surgical navigation which processes information interactively between the real and virtual spaces, namely, updating preoperative images using the positional information of surgical tools. Although the organs are deformed by operative procedures during surgery, surgical navigation systems usually do not change the reference images that are taken prior to surgery. It is useful to generate deformed reference images during surgery while it progresses. We develop a skull base surgery navigation system that updates the preoperative images during surgery. To estimate the resected regions, our proposed system utilizes the positional information of the surgical tools that can be tracked by a surgical navigation system. Our proposed system reflects the bone removal on preoperative images by changing the voxel values of the preoperative images using the positional information of the tracked tools. The updated reference images are generated by visualizing the updated preoperative images using a volume rendering method. We evaluated the proposed system on a skull phantom created from CT images by a 3D printer. The experimental results showed that the proposed system updated the reference images in real time based on the surgical tasks including bone removal process. The accuracy of our proposed method was about 1 mm. It is very useful for surgeons to drill into such complex bone structure as the skull base.

Automatic Surgical Workflow Estimation Method for Brain Tumor Resection Using Surgical Navigation Information

2012 ◽  
Vol 24 (5) ◽  
pp. 791-801 ◽  
Author(s):  
Ryoichi Nakamura ◽  
◽  
Tomoaki Aizawa ◽  
Yoshihiro Muragaki ◽  
Takashi Maruyama ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Navigation System ◽  
Surgical Navigation ◽  
Process Analysis ◽  
Tumor Resection ◽  
Estimation Method ◽  
Tumor Removal ◽  
Surgical Navigation System ◽  
Automatic Estimation ◽  
Surgical Tool

It has been acknowledged as a problem in recent years that surgery has become complex due to medical system updating. To respond to the increasing demand for making surgery more optimal and efficient, studies on surgical process analysis have attracted attention. Automatic estimation technology is necessary for accurate and efficient process analysis. With a focus on this problem, we have studied technologies on the automatic estimation of surgical processes. In this study, we develop an automatic estimationmethod for a chosen surgical process on the basis of information obtained from a surgical navigation system, taking as an example image-guided brain tumor surgery. We found a significant correlation among five parameters – progress in enucleation, depth of surgical tool tip, displacement of surgical tool, volume of surgical tool position log data, and number of events detected during surgery – that are defined according to the anatomical information on patients and surgical procedure information on surgeons stored in the navigation system, and three stages in the brain tumor removal process: (1) incision of the surface cortex, (2) testing and blood vessel resection, (3) resection and removal of tumors. By using automatic Bayesian estimation of tumor removal processes in eight case examples using the five parameters, we estimated 73% of all processes correctly. This result indicates that surgical processes are automatically estimated with information in the surgical navigation system alone, which thus contributes to the accurate and efficient surgery analysis.

scholarly journals Accuracy assessment of target tracking using two 5-degrees-of-freedom wireless transponders

2019 ◽  
Vol 15 (2) ◽  
pp. 369-377
Author(s):  
Roeland Eppenga ◽  
Koert Kuhlmann ◽  
Theo Ruers ◽  
Jasper Nijkamp
Keyword(s):  
Degrees Of Freedom ◽  
Surgical Navigation ◽  
Tracking System ◽  
Optical Tracking ◽  
Navigation Systems ◽  
Optical Tracking System ◽  
Worst Case ◽  
Tumor Tracking ◽  
Surgical Tool ◽  
Vector Information

Abstract Purpose Surgical navigation systems are generally only applied for targets in rigid areas. For non-rigid areas, real-time tumor tracking can be included to compensate for anatomical changes. The only clinically cleared system using a wireless electromagnetic tracking technique is the Calypso® System (Varian Medical Systems Inc., USA), designed for radiotherapy. It is limited to tracking maximally three wireless 5-degrees-of-freedom (DOF) transponders, all used for tumor tracking. For surgical navigation, a surgical tool has to be tracked as well. In this study, we evaluated whether accurate 6DOF tumor tracking is possible using only two 5DOF transponders, leaving one transponder to track a tool. Methods Two methods were defined to derive 6DOF information out of two 5DOF transponders. The first method uses the vector information of both transponders (TTV), and the second method combines the vector information of one transponder with the distance vector between the transponders (OTV). The accuracy of tracking a rotating object was assessed for each method mimicking clinically relevant and worst-case configurations. Accuracy was compared to using all three transponders to derive 6DOF (Default method). An optical tracking system was used as a reference for accuracy. Results The TTV method performed best and was as accurate as the Default method for almost all transponder configurations (median errors < 0.5°, 95% confidence interval < 3°). Only when the angle between the transponders was less than 2°, the TTV method was inaccurate and the OTV method may be preferred. The accuracy of both methods was independent of the angle of rotation, and only the OTV method was sensitive to the plane of rotation. Conclusion These results indicate that accurate 6DOF tumor tracking is possible using only two 5DOF transponders. This encourages further development of a wireless EM surgical navigation approach using a readily available clinical system.

Fuzzy Controller for Positioning Tasks in Tactile Surgical Navigation

2011 ◽  
Vol 403-408 ◽  
pp. 4794-4799
Author(s):  
Stanley A. Mungwe ◽  
Andreas Hein
Keyword(s):  
Navigation System ◽  
Fuzzy Controller ◽  
Surgical Navigation ◽  
System Model ◽  
Feedback Information ◽  
Positioning Control ◽  
Surgical Navigation System ◽  
Surgical Tool ◽  
Analytical System

This paper presents a fuzzy controller for positioning control with a newly developed surgical navigation system which uses tactile signals as feedback to the operator. The advantage of using tactile vibrations to transmit feedback information about the position of the surgical tool relative to particular tissues is the reduction of the contant gaze of the operator from the field of operation to a remote screen. The Fuzzy controller was derived without any analytical system model and its efficiency was compared to that of an already developed classical controller.

scholarly journals Optimal Targeting Display for Navigated Pelvic Screw Insertions

10.29007/srn7 ◽  
2020 ◽  
Author(s):  
Prashant Pandey ◽  
Pierre Guy ◽  
Kelly Lefaivre ◽  
Antony J. Hodgson
Keyword(s):  
Patient Safety ◽  
Navigation System ◽  
Opportunity Cost ◽  
Surgical Navigation ◽  
Iliosacral Screw ◽  
Navigation Systems ◽  
Measurable Effect ◽  
Navigated Surgery ◽  
Time Required ◽  
The Impact

Surgical navigation can be used for complex orthopaedic procedures, such as iliosacral screw fix- ations, to achieve accurate and efficient results [11]. Although there have been studies studying the impact of navigation systems on surgical outcomes [6, 3], we are not aware of any studies that have quantified the effect of how information regarding the surgical navigation scene is displayed to surgeons on conventional monitors. However, the display of information can have a measurable effect on both accuracy and time required to perform the navigated surgery, as the surgical scene can be presented in many different formats [9]. Optimizing surgical accuracy potentially helps improves patient safety by reducing screw malplacement [11], while optimiz- ing time efficiency reduces opportunity cost [1]. Therefore, we designed a study to determine the optimal visualizations for performing navigated pelvic screw insertions. The findings of this study can be used to more systematically design visualization components of a navigation system.

scholarly journals Accuracy and Precision of a Surgical Navigation System: Effect of Camera and Patient Tracker Position and Number of Active Markers

2017 ◽  
Vol 11 (1) ◽  
pp. 493-501 ◽  
Author(s):  
Kenneth R. Gundle ◽  
Jedediah K. White ◽  
Ernest U. Conrad ◽  
Randal P. Ching
Keyword(s):  
Navigation System ◽  
Repeated Measures ◽  
Surgical Navigation ◽  
Navigation Systems ◽  
Test Environment ◽  
System Effect ◽  
Surgical Navigation System ◽  
Accuracy And Precision ◽  
Rms Error ◽  
Surgical Navigation Systems

Introduction: Surgical navigation systems are increasingly used to aid resection and reconstruction of osseous malignancies. In the process of implementing image-based surgical navigation systems, there are numerous opportunities for error that may impact surgical outcome. This study aimed to examine modifiable sources of error in an idealized scenario, when using a bidirectional infrared surgical navigation system. Materials and Methods: Accuracy and precision were assessed using a computerized-numerical-controlled (CNC) machined grid with known distances between indentations while varying: 1) the distance from the grid to the navigation camera (range 150 to 247cm), 2) the distance from the grid to the patient tracker device (range 20 to 40cm), and 3) whether the minimum or maximum number of bidirectional infrared markers were actively functioning. For each scenario, distances between grid points were measured at 10-mm increments between 10 and 120mm, with twelve measurements made at each distance. The accuracy outcome was the root mean square (RMS) error between the navigation system distance and the actual grid distance. To assess precision, four indentations were recorded six times for each scenario while also varying the angle of the navigation system pointer. The outcome for precision testing was the standard deviation of the distance between each measured point to the mean three-dimensional coordinate of the six points for each cluster. Results: Univariate and multiple linear regression revealed that as the distance from the navigation camera to the grid increased, the RMS error increased (p<0.001). The RMS error also increased when not all infrared markers were actively tracking (p=0.03), and as the measured distance increased (p<0.001). In a multivariate model, these factors accounted for 58% of the overall variance in the RMS error. Standard deviations in repeated measures also increased when not all infrared markers were active (p<0.001), and as the distance between navigation camera and physical space increased (p=0.005). Location of the patient tracker did not affect accuracy (0.36) or precision (p=0.97) Conclusion: In our model laboratory test environment, the infrared bidirectional navigation system was more accurate and precise when the distance from the navigation camera to the physical (working) space was minimized and all bidirectional markers were active. These findings may require alterations in operating room setup and software changes to improve the performance of this system.

Endonasal Transsphenoidal Pituitary Surgery: Institutional Review of Initial Experience

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
Bakhtiyar Pashaev ◽  
Valery Danilov ◽  
Gulnar Vagapova ◽  
Vladimir Bochkarev ◽  
Farida Nasibullina ◽  
...  
Keyword(s):  
Pituitary Surgery ◽  
Initial Experience ◽  
Institutional Review ◽  
Transsphenoidal Pituitary Surgery
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