Int J Med Robot - A navigation system for open liver surgery: design, workflow and first clinical applications.

Tópicos

{ surgeri(1148) surgic(1085) robot(1054) }
{ imag(1057) registr(996) error(939) }
{ visual(1396) interact(850) tool(830) }
{ ehr(2073) health(1662) electron(1139) }
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{ care(1570) inform(1187) nurs(1089) }
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{ monitor(1329) mobil(1314) devic(1160) }
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{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
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{ sequenc(1873) structur(1644) protein(1328) }
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{ high(1669) rate(1365) level(1280) }
{ use(976) code(926) identifi(902) }
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Resumo

CKGROUND: The surgical treatment of liver tumours relies on precise localization of the lesions and detailed knowledge of the patient-specific vascular and biliary anatomy. Detailed three-dimensional (3D) anatomical information facilitates complete tumour removal while preserving a sufficient amount of functional liver tissue.METHODS: We present an easy to use, clinically applicable navigation system for efficient visualization and tool guidance during liver surgery. Accurate instrument guidance within 3D planning models was achieved with a fast registration procedure, assuming a locally rigid and temporarily static scenario. After deformations occurring during the procedure, efficient means for registration updates are provided. Special focus was given to workflow integration and the minimization of overhead time. The navigation system was validated with nine clinical cases.RESULTS: Navigated surgical interventions were performed with a median time overhead of 16.5 min. The navigation technology had a median accuracy of 6.3 mm, improving anatomical orientation and the detection of structures at risk.CONCLUSIONS: Successful application of the navigation technology to open liver surgery was achieved by minimizing the procedural complexity and optimizing integration within the existing surgical environment. The assumption of locally rigid patient registration was validated, and clinical evaluation shows clear benefits for the surgeon.

Resumo Limpo

ckground surgic treatment liver tumour reli precis local lesion detail knowledg patientspecif vascular biliari anatomi detail threedimension d anatom inform facilit complet tumour remov preserv suffici amount function liver tissuemethod present easi use clinic applic navig system effici visual tool guidanc liver surgeri accur instrument guidanc within d plan model achiev fast registr procedur assum local rigid temporarili static scenario deform occur procedur effici mean registr updat provid special focus given workflow integr minim overhead time navig system valid nine clinic casesresult navig surgic intervent perform median time overhead min navig technolog median accuraci mm improv anatom orient detect structur riskconclus success applic navig technolog open liver surgeri achiev minim procedur complex optim integr within exist surgic environ assumpt local rigid patient registr valid clinic evalu show clear benefit surgeon

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