Abstract
Objects We have developed a new MR-compatible laparoscope that incorporates a distally mounted charge-coupled device (CCD). The MR-compatibility and feasibility of laparoscopy using the new laparoscope were evaluated during MR image-guided laparoscopic radiofrequency ablation therapy (RFA).
Materials and methods MR compatibility of the laparoscope was investigated in terms of MR image artifact caused by electromagnetic interference (EMI) and susceptibility. MR images were obtained using spin echo and gradient echo pulse sequences with a 0.3 T open MRI unit. We performed an in vivo experiment with MR image-guided laparoscopic RFA on three pigs; near real-time MR images and 3-D navigation were possible using intraoperative MR images. Agarose gel was injected into the pigs’ livers as puncture targets; the diameter of each target was approximately 20 mm.
Results Artifacts resulting from EMI were not found in phantom experiments. MR image-guided laparoscopic RFA was successfully performed in all procedures. Both the laparoscopic vision and near real-time MR images were clear. No artifact was detected on the MR images and the surgeon was able to confirm the true position of the probe and target during treatment using the near real-time MR images.
Conclusion Laparoscopic surgery is feasible under intraoperative MR image-guidance using a newly developed MR-compatible laparoscope with a distally mounted CCD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Muragaki Y, Maruyama T, Iseki H, Hori T and Takakura K (2004). Intraoperative MRI and updated navigation. Nippon Rinsho 62(4): 697–706
Hashizume M, Takenaka K, Sugimachi K, Hepatectomy (1996) In: McFadyen BV Jr., Ponsky JL (eds) Operative laparoscopy and thoracoscopy, Lippincott-Raven, Phiadelphia, pp 387–408
Melzer A, Schmidt A, Kipfmüller K, Grönemeyer D, Seibel R (1997) MR-compatible instruments for interventional MR. In: Fuflin RB (ed) Interventional MRI. Mosby, St. Louis, pp 55–69
Morikawa S, Inubushi T, Kurumi Y, Naka S, Sato K, Tani T, Haque HA, Tokuda J and Hata N (2003). New assistive devices for MR-guided microwave thermocoagulation of liver tumors. Acad Radiol 10(2): 180–88
Lauro A, Gould SW, Cirocchi R, Giustozzi G and Darzi A (2004). Laparoscopic and general surgery guided by open interventional magnetic resonance. Minerva chirurgica 59(5): 507–16
Kataoka H, Chinzei K, Washio T, Iseki H, Hori T and Fukuyo T (2000). Development of MR Compatible Endoscope. proc JSCAS 2000: 173–174
Hayes DL, Holmes DR and Gray JE (1987). Effect of 1.5 tesla nuclear magnetic resonance imaging scanner on implanted permanent pacemakers. J Am Coll Cardiol 10(4): 782–786
Designation:F2119–01 (2007) Standard test method for evaluation of mr image artifacts from passive implants, ASTM International, West conshohocken
Olympus News Release (2004) Olympus EndoEYETM. Surgical Videoscope Receives “Innovation of the Year Award” From Society of Laparoendoscopic Surgeons
Frank G. Shellock, Vincent J. Shellock (1998) Spelzer Titanium Aneurysm Clips: Compatibility at MR Imaging. Radiology. 206(3):838–841
Gould SWT, Gedroyc W and Darzi A (1999). Laparoscopic surgery in a 0.5-t interventional magnetic resonance unit. Surg Endosc 13: 604–610
Woods TO (2003) MRI Safety and compatibility of implants and medical devices, stainless steels for medical and surgical applications, ASTM STP 1438. In: Winters GL, Nutt MJ (eds) ASTM International, West Conshohocken
Santambrogio R, Bianchi P, Palmisano A, Donadon M, Moroni E and Montorsi M (2003). Radiofrequency of hepatocellular carcinoma in patients with liver cirrhosis: a critical appraisal of the laparoscopic approach. J Exp Clin Cancer Res 22(4): 251–255
Santambrogio R, Podda M, Zuin M, Bertolini E, Bruno S, Comalba GP, Cosa M and Montorsi M (2003). Safety and efficacy of laparoscopic radiofrequency of Hepatocellular carcinoma in patients with liver cirrhosis. Surg Endosc 17: 1826–32
Dodd 3rd GD, Mller WJ, Baron RL, Skolnick ML and Campbell WL (1992). Detection of malignant tumors in end-stage cirrhotic livers: efficacy of sonography as a screening technique. AJR Am J Roentgenol 159: 727–733
Kim CK, Lim JH and Lee WJ (2001). Detection of Hepatocellular carcinomas and dysplastic nodules in cirrhotic liver: accuracy of ultrasonography in transplant patients. J Ultrasound Med 20: 99–104
Kim YJ, Raman SS, Yu NC and Lu DSK (2005). MR-guided percutaneous ethanol injection for hepatocellular carcinoma in a 0.2 T open MR system. J Magn Reson Imaging 22: 566–571
Martin RCG (2005). Intraoperative magnetic resonance imaging ablation of hepatic tumors. Am J Surg 189: 388–394
Nickkholgh A, Soltaniyekta S and Kalbasi H (2006). Routine versus selective intraoperative cholangiography during laparoscopic cholecystectomy: a survey of 2,130 patients undergoing laparoscopic cholecystectomy. Surg Endosc 20(6): 868–74
Mack MG, Balzer JO, Straub R, Eichler K and Vogl TJ (2002). Superparamagnetic iron oxide-enhanced MR imaging of head and neck lymph nodes. Radiology 222: 239–244
Kato M, Saji S, Kanematsu M, Fukada D, Miya K, Umemoto T, Kunieda K, Sugiyama Y, Takao H, Kawaguchi Y, Takagi Y, Kondo H and Hoshi H (1999). Detection of Lymph-node metastases in patients with gastric carcinoma: comparison of three MR imaging pulse sequences. Abdom Imaging 25: 25–29
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yasunaga, T., Konishi, K., Yamaguchi, S. et al. MR-compatible laparoscope with a distally mounted CCD for MR image-guided surgery. Int J CARS 2, 11–18 (2007). https://doi.org/10.1007/s11548-007-0076-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-007-0076-6