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.

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 First experience with augmented reality neuronavigation in endoscopic assisted midline skull base pathologies in children

2021 ◽  
Author(s):  
Valentina Pennacchietti ◽  
Katharina Stoelzel ◽  
Anna Tietze ◽  
Erwin Lankes ◽  
Andreas Schaumann ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Morphological Variability ◽  
Case Series ◽  
Relevant Information ◽  
Navigation Systems ◽  
Postoperative Mri ◽  
The Mean ◽  
Clinical Conditions

Abstract Introduction Endoscopic skull base approaches are broadly used in modern neurosurgery. The support of neuronavigation can help to effectively target the lesion avoiding complications. In children, endoscopic-assisted skull base surgery in combination with navigation systems becomes even more important because of the morphological variability and rare diseases affecting the sellar and parasellar regions. This paper aims to analyze our first experience on augmented reality navigation in endoscopic skull base surgery in a pediatric case series. Patients and methods A retrospective review identified seventeen endoscopic-assisted endonasal or transoral procedures performed in an interdisciplinary setting in a period between October 2011 and May 2020. In all the cases, the surgical target was a lesion in the sellar or parasellar region. Clinical conditions, MRI appearance, intraoperative conditions, postoperative MRI, possible complications, and outcomes were analyzed. Results The mean age of our patients was 14.5 ± 2.4 years. The diagnosis varied, but craniopharyngiomas (31.2%) were mostly represented. AR navigation was experienced to be very helpful for effectively targeting the lesion and defining the intraoperative extension of the pathology. In 65% of the oncologic cases, a radical removal was proven in postoperative MRI. The mean follow-up was 89 ± 79 months. There were no deaths in our series. No long-term complications were registered; two cerebrospinal fluid (CSF) fistulas and a secondary abscess required further surgery. Conclusion The implementation of augmented reality to endoscopic-assisted neuronavigated procedures within the skull base was feasible and did provide relevant information directly in the endoscopic field of view and was experienced to be useful in the pediatric cases, where anatomical variability and rarity of the pathologies make surgery more challenging.

Augmented Reality for Retrosigmoid Craniotomy Planning

2021 ◽  
Author(s):  
Caio A. Neves ◽  
Christoph Leuze ◽  
Alejandro M. Gomez ◽  
Nassir Navab ◽  
Nikolas Blevins ◽  
...  
Keyword(s):  
Medical Imaging ◽  
Augmented Reality ◽  
Surgical Navigation ◽  
Internal Auditory Canal ◽  
Navigation Systems ◽  
Imaging Data ◽  
Dural Sinuses ◽  
Bone Removal ◽  
Surgical Navigation Systems ◽  
Medical Imaging Data

AbstractWhile medical imaging data have traditionally been viewed on two-dimensional (2D) displays, augmented reality (AR) allows physicians to project the medical imaging data on patient's bodies to locate important anatomy. We present a surgical AR application to plan the retrosigmoid craniotomy, a standard approach to access the posterior fossa and the internal auditory canal. As a simple and accurate alternative to surface landmarks and conventional surgical navigation systems, our AR application augments the surgeon's vision to guide the optimal location of cortical bone removal. In this work, two surgeons performed a retrosigmoid approach 14 times on eight cadaver heads. In each case, the surgeon manually aligned a computed tomography (CT)-derived virtual rendering of the sigmoid sinus on the real cadaveric heads using a see-through AR display, allowing the surgeon to plan and perform the craniotomy accordingly. Postprocedure CT scans were acquired to assess the accuracy of the retrosigmoid craniotomies with respect to their intended location relative to the dural sinuses. The two surgeons had a mean margin of davg = 0.6 ± 4.7 mm and davg = 3.7 ± 2.3 mm between the osteotomy border and the dural sinuses over all their cases, respectively, and only positive margins for 12 of the 14 cases. The intended surgical approach to the internal auditory canal was successfully achieved in all cases using the proposed method, and the relatively small and consistent margins suggest that our system has the potential to be a valuable tool to facilitate planning a variety of similar skull-base procedures.

scholarly journals Use of the LandmarX™ Surgical Navigation System in Lateral Skull Base and Temporal Bone Surgery

Skull Base ◽  
2001 ◽  
Vol 11 (04) ◽  
pp. 245-256 ◽  
Author(s):  
Hinrich Staecker ◽  
Bert W. O'Malley ◽  
Howard Eisenberg ◽  
B. Emmerich Yoder
Keyword(s):  
Skull Base ◽  
Temporal Bone ◽  
Navigation System ◽  
Surgical Navigation ◽  
Bone Surgery ◽  
Surgical Navigation System ◽  
Temporal Bone Surgery ◽  
Lateral Skull Base

scholarly journals BRAIN TUMOR SURGERY NAVIGATION SYSTEM BASED ON UPDATING PREOPERATIVE IMAGES USING POSITIONAL INFORMATION OF SURGICAL TOOLS

2014 ◽  
Vol 16 (suppl 3) ◽  
pp. iii14-iii14
Author(s):  
T. Wakabayashi ◽  
M. Fujii ◽  
A. Natsume ◽  
K. Motomura ◽  
Y. Hayashi ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Navigation System ◽  
Positional Information ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Surgical Tools
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