Transrectal Ultrasound Image-based Real-time Augmented Reality Guidance in Robot-assisted Laparoscopic Rectal Surgery: A Proof of Concept Study

Abstract : Purpose: Surgical treatments for low rectal cancer require careful considerations due to the low location of cancer in rectums. Successful sur- gical outcomes highly depend on surgeons' ability to determine clear distal margins of rectal tumors. This is a challenge for surgeons in robot-assisted laparoscopic surgery, since tumors are often concealed in rectums and robotic surgical instruments do not provide tactile feedback for tissue diagnosis in real-time. This paper presents the development and evaluation of an intraop- erative ultrasound-based augmented reality framework for surgical guidance in robot-assisted rectal surgery. Methods: Framework implementation consists in calibrating the transrectal ultrasound (TRUS) and the endoscopic camera (hand-eye calibration), generating a virtual model and registering it to the endoscopic image via optical tracking, and displaying the augmented view on a head-mounted display. An experimental validation setup is designed to eval- uate the framework. Results: The evaluation process yields a mean error of 0:9 mm for the TRUS calibration, a maximum error of 0:51 mm for the hand- eye calibration of endoscopic cameras, and a maximum RMS error of 0:8 mm for the whole framework. In the experiment with a rectum phantom, our frame- work guides the surgeon to accurately localize the simulated tumor and the distal resection margin. Conclusion: This framework is developed with our clinical partner, based on actual clinical conditions. The experimental proto- col and the high level of accuracy show the feasibility of seamlessly integrating this framework within the surgical workow.
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https://hal-lirmm.ccsd.cnrs.fr/lirmm-02381958
Contributor : Nabil Zemiti <>
Submitted on : Tuesday, November 26, 2019 - 10:12:37 PM
Last modification on : Monday, January 13, 2020 - 1:17:24 AM

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Jun Shen, Nabil Zemiti, Christophe Taoum, Guillaume Aiche, Jean-Louis Dillenseger, et al.. Transrectal Ultrasound Image-based Real-time Augmented Reality Guidance in Robot-assisted Laparoscopic Rectal Surgery: A Proof of Concept Study. International Journal of Computer Assisted Radiology and Surgery, Springer Verlag, 2019, ⟨10.1007/s11548-019-02100-2⟩. ⟨lirmm-02381958⟩

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