Navigasjon og intraoperativ avbildning i laparoskopisk kirurgi.
The objective of this project is to develop a permanent liver phantom using real human liver vasculature and vascular corrosion casting technique as a basis. The phantoms are developed for teaching, training and equipment development purposes in the field of laparoscopic ultrasound in combination with navigation technology. Detection of vasculature and tumors were the main focus. With liver malignancy in focus, life-like phantoms, with correct anatomic detail, are necessary for optimizing imaging and guidance technology development for laparoscopic liver surgery. Preoperative CT images used with navigation technology and laparoscopic ultrasound in guidance, signifies the importance of the multimodal nature of the phantoms. To our knowledge, multimodal liver phantoms made by replicating real human tissue do not exist. The closest alternative that is available, is an artificial phantom (cross section of the abdomen) from CIRS Inc., providing a training phantom for such procedures as ultrasound guided needle injection for e.g. biopsies. Another pahantom, representing the upper abdominal organs is ISUFAN®. The phantom is not multimodal, it is designed for abdominal intraoperative and laparoscopic US. This phantom is also very expensive and delicate to handle, and it isn’t suitable for invasive procedures The objective of this project is to develop methods that permanently preserve real human organs and/or their vasculature with the purpose of using these as phantoms for teaching, training and equipment development purposes in the field of laparoscopic ultrasound in combination with navigation technology. We aim to develop anatomically relevant liver phantom using vascular corrosion casting technique as a basis. The goal was to produce a simple, robust ,permanent and cost effective liver phantom to be used primarily for training in operative planning with navigated laparoscopic ultrasound. Detection of vasculature and tumors were the main focus
For many surgical procedures, the method of choice has shifted from traditional open surgery to less invasive interventions, e.g. laparoscopic techniques. Minimally invasive procedures have the advantage of reducing the trauma and the recovery time and, hence, also the costs related to postoperative follow-up of the patients. The drawbacks of minimally invasive techniques are restricted vision of the surgical field and difficult hand-eye coordination. Hence, there is a need for improved visualization and technology when planning the procedure and for control and guidance during treatment in minimally invasive therapy. The National centre for 3D ultrasound has through several years developed intraoperative ultrasound solutions and navigation technology for minimally invasive image guided surgery. The overall goal of this project is to evaluate laparoscopic ultrasound (LUS), both 2D and 3D, as a tool for enhanced visualization and improved quality control during laparoscopic liver resections. The tools will also be applicable to other procedures like laparoscopic adrenalectomy. The main clinical objective is to solve the orientation problem during LUS guidance and also enable the use of navigated preoperative images (MR or CT) inside the OR. Furthermore, we hope to improve the understanding of tumor location and allow for better approach and access with the following projects: 1. In the OR planning for laparoscopic liver resection 2. Fast registration of preoperative data for navigation in laparoscopic surgery 3. Probe calibration for flexible laparoscopic ultrasound: accuracy, methodology, and intraoperative aspects for an innovative solution 4. Quick intraoperative attachment and calibration of laparoscopic instruments for navigation in laparoscopy 5. 3D ultrasound in laparoscopy: clinical value in delineation and localization of tumors and staging 6. Navigated ultrasound during laparoscopic liver resection
Rethy A, Saeternes JO, Marvik R, Lango T
Multimodal liver phantom