Abstract
Purpose
In most orthopedic surgeries, knowing how far to insert surgical tools is crucial. The objective of this study was to provide guidance information on depth without tracking surgical tools. A previously developed laser guidance system for linear surgical tool insertion uses two laser beams that display the insertion point and orientation on the skin surface. However, the system only provides 4 degrees of freedom guidance (an entry point on the planned pathway line and the orientation) but do not inform surgeons on the ideal insertion depth.
Method
A 5-DOF guidance method was developed to provide guidance information by direct projection onto the surgical area using laser beams without tracking markers. A position and orientation guidance performed by two laser beams and depth guidance performed by a single laser beam are appeared on the surgical area in turn. However, depth point appears on the surgical tool side face with some error because of tool radius. Using the actual depth position, insertion path vector and location of the laser sources, the correct depth point on the tool’s surface is calculated by the proposed method. So, this system can indicate and navigate the 5-DOF which is planning path and the correct depth point.
Results
An evaluation of the accuracy of depth guidance revealed a depth guidance error of \(0.55\pm 0.29\) mm and results from phantom target insertions revealed overall system accuracies of \(1.44 \pm 1.09\) mm, \(0.91^{\circ }\pm 0.82^{\circ }\). In addition, overall system accuracies of application feasibility experiment under the X-ray condition were \(1.94 \pm 0.98\,\hbox {mm}, 1.39^{\circ } \pm 1.30^{\circ }\).
Conclusion
A new surgical tool depth insertion method was developed using a fluorolaser guidance system. This tool informs surgeons of the surgical tool tip depth assuming that the insertion point and orientation are correct. The new method was tested successfully in vitro.
Similar content being viewed by others
References
Fuchs H, State A, Pisano ED et al (1996) Towards performing ultrasound-guided needle biopsies from within a head-mounted display. Lect Notes Comput Sci 1131:591–600
Blackwell M, Nikou C, DiGioia AM et al (1998) An image overlay system for medical data visualization. Lect Notes Comput Sci 1496:232–240
Fichtinger G, Deguet A, Masamune K et al (2005) Image overlay guidance for needle insertion in CT scanner. IEEE Trans Bioemed Eng 52(8):1415–1424
Liao H, Ishihara H, Tran HH et al (2008) Fusion of laser guidance and 3-d autostereoscopic image overlay for precision-guided surgery. Lect Notes Comput Sci 5128:367–376
Volonte F, Pugin F, Bucher P et al (2011) Augmented reality and image overlary navigation with OsiriX in laparoscopic and robotic surgery: not only a matter of fashion. J Hepatobiliary Pancreat Sci 18:506–509
Malik JM, Kamiryo T, Goble J et al (1995) Stereotactic laser-guided approach to distal middle cerebral artery aneurysms. Acta Neurochirurgica 132:138–144
Lavallee S, Toroccaz J, Sautot P et al (1996) Computer-assisted spinal surgery using anatomiy-based registration. Computer-integrated surgery: technology and clinical applications. MIT Press, Cambridge
Hussman KL, Chalouplca JC, Berger SB (1998) Frameless laser-guided stereotaxis: a system for CT-monitored neurosurgical interventions. Stereotect Funct Neurosurg 71:62–75
Glossop N, Wedlake C, Moore J et al (2002) Laser projection augumented reality system for computer assited surgery. Lect Notes Comput Sci 2879:239–246
Marmurek J, Wedlake C, Pardasani U et al (2006) Image-guided laser projection for port placement in minimally invasive surgery. Stud Health Technol Inform 119:367–372
Nitta N, Takahashi M, Tanaka T et al (2007) Laser-guided computed tomography puncture system: simulation experiments using artificial phantom lesions and preliminary clinical experience. Radiat Med 25(4):187–193
Sasama T, Sugano N, Sato Y, Momoi Y, Koyama T, Nakajima Y, Sakuma I, Fujie M, Yonenobu K, Ochi T, Tamura S (2002) A novel laser guidance system for alignment of linear surgical tools: its principles and performance evaluation as a man–machine system medical image computing and computer-assisted intervention—MICCAI 2002. In: Dohi T, Kikinis R (eds) vol 2489. Lecture notes in computer science. Springer, Berlin, pp 25–132. doi:10.1007/3-540-45787-9_16
Liang JT, Doke T, Onogi S, Ohashi S, Ohnishi I, Sakuma I, Nakajima Y (2012) A fluorolaser navigation system to guide linear surgical tool insertion. Int J Comput Assist Radiol Surg 7(6):931–939. doi:10.1007/s11548-012-0743-0
Nakajima Y, Dohi T, Sasama T, Momoi Y, Sugano N, Tamura Y, Lim S, Sakuma I, Mitsuishi M, Koyama T, Yonenobu K, Ohashi S, Bessho M, Ohnishi I (2012) Surgical tool alignment guidance by drawing two cross-sectional laser-beam planes. IEEE Trans Biomed Eng 60(6):1467–1476
Abumi K, Shono Y, Ito M, Taneichi H, Kotani Y, Kaneda K (2000) Com-plications of pedicle screw fixation in reconstructive surgery of the cervicalspine. Spine 25:962–969
Belkoff S, Molloy S (2003) Temperature measurement during polymerization of polymethylmethacrylate cement used for vertebroplasty. Spine 28:1555–1559
Gavaghan K, Oliveira-Santos T, Peterhans M, Reyes M, Kim H, Anderegg S, Weber S (2012) Evaluation of a portable image overlay projector for the visualization of surgical navigation data: phantom studies. Int J Comp Assis Radio Surg 7:547–556
Gavaghan K, Oliveira-Santos T, Peterhans M, Reyes M, Kim H, Anderegg S, Weber S (2001) Virtual fluoroscopy: computer-assisted fluoroscopic navigation. Spine 26:347–351
Hofstetter R, Slomczykowski M, Sati M, Nolte L (1999) Fluoroscopy as an imaging means for computer-assisted surgical navigation. Comp Assis Surg 4:65–76
Bellemare M, Acosta O, Goksu C, Kulik C, Rioual K, Lu-cas A (2004) Depth-map-based scene analysis for active navigation in virtual angioscopy. IEEE Trans Med Img 23:1380–1390
Smithwick Q, Seibel E eds (2002) Depth enhancement using a scanning fiber optical endoscope. In: Proceedings of SPIE BiOS
Schick U, Dohnert J (2002) Technique of microendoscopy in medial lumbar disc herniation. Minim Invasive Neurosurg 45:139–141
Tonetti J, Carrat L, Blendea S, Merloz P, Troccaz J, Lavallee S, Chirossel J (2001) Clinical results of percutaneous pelvic surgery. Computer assisted surgery using ultrasound compared to standard fluoroscopy. Comp Aided Surg 6:204–211
Nakajima Y, Yamamoto H, Sato Y, Sugano N, Momoi Y, Sasama T, Koyama T, Tamura Y, Yonenobu K, Sakuma I, Yoshikawa H, Ochi T, Tamura S (2004) Available range analysis of laser guidance system and its application to monolithic integration with optical tracker. Int Congress Ser 1268:449–454
Lim S, Douke T, Onogi S, Nakajima Y, Mitsuishi M, Sakuma I, Bessho M, Ohnishi I, Nakamura K (2010) Assessment for the feasibility of external-fixation pin guidance using laser navigation. Jpn Soc Comput Aided Surg 12:511–518
Navab N, Mitschke M, Schutz O (1999), Camera-augmented mobile c-arm (camc) application: 3d reconstruction using a low-cost mobile c-arm. In: Lecture notes in computer science, vol 1679. MICCAI’99, pp 688–697
Ferreira S, Bruns R, Ferreira H, Matos G, David J, brandao G, Silva E, Portugal L, Reis P, Souza A, Santos W (2007) Box-behnken design: an alternative for the optimization of analytical methods. Analytica Chimica Acta 597:179–186
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Doke, T., Liang, J.T., Onogi, S. et al. Fluoroscopy-based laser guidance system for linear surgical tool insertion depth control. Int J CARS 10, 275–283 (2015). https://doi.org/10.1007/s11548-014-1079-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-014-1079-8