Skip to main content
SpringerLink
Log in

Upgrade of an optical navigation system with a permanent electromagnetic position control

A first step towards “navigated control” for liver surgery

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Introduction

The main problems of navigation in liver surgery are organ movement and deformation. With a combination of direct optical and indirect electromagnetic tracking technology, visualisation and positional control of surgical instruments within three-dimensional ultrasound data and registration of organ movements can be realised simultaneously.

Methods

Surgical instruments for liver resection were localised with an infrared-based navigation system (Polaris®). Movements of the organ itself were registered using an electromagnetic navigation system (Aurora®). The combination of these two navigation techniques and a new surgical navigation procedure focussed on a circumscribed critical dissection area were applied for the first time in liver resections.

Results

This new technique was effectively implemented. The position of the surgical instrument was localised continuously. Repeated position control with observation of the navigation screen was not necessary. During surgical resection, a sonic warning signal was activated when the surgical instrument entered a “no touch” area—an area of reduced safety margin.

Conclusion

Optical tracking of surgical instruments and simultaneous electromagnetic registration of organ position is feasible in liver resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Joyce DL, Wahl RL, Patel PV, et al. Preoperative positron emission tomography to evaluate potentially respectable hepatic colorectal metastases. Arch Surg. 2006;141:1220–6.

    Article  PubMed  Google Scholar 

  2. Hohlweg-Majert B, Schon R, Schmelzeisen R, et al. Navigational maxillofacial surgery using virtual models. World J Surg. 2005;29:1530–8.

    Article  PubMed  CAS  Google Scholar 

  3. Hamada H, Hayashi N, Asahi T, et al. Efficacy of a navigation system in neuro-endoscopic surgery. Minim Invasive Neurosurg. 2005;48:197–201.

    Article  PubMed  CAS  Google Scholar 

  4. Lang H, Radtke A, Hindennach M, et al. Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection. Arch Surg. 2005;140:629–38.

    Article  PubMed  Google Scholar 

  5. Satava RM. Emerging technologies for surgery in the 21st century. Arch Surg. 1999;134:1197–202.

    Article  PubMed  CAS  Google Scholar 

  6. Herline AJ, Stefansic JD, Debelak JP, et al. Image-guided surgery: preliminary feasibility studies of frameless stereotactic liver surgery. Arch Surg. 1999;134:644–9.

    Article  PubMed  CAS  Google Scholar 

  7. Beller S, Hünerbein M, Eulenstein S et al. Feasibility of navigated resection of liver tumors using multiplanar visualization of intreaoperative 3D ultrasound data. Ann Surg. 2007;246:288–94.

    Google Scholar 

  8. Kleemann M, Hildebrand P, Birth M, et al. Laparoscopic ultrasound navigation in liver surgery: technical aspects and accuracy. Surg Endosc. 2006;20:726–9.

    Article  PubMed  CAS  Google Scholar 

  9. Marvik R, Lango T, Tangen GA, et al. Laparoscopic navigation pointer for three-dimensional image-guided surgery. Surg Endosc. 2004;18:1242–8.

    Article  PubMed  CAS  Google Scholar 

  10. Lange T, Eulenstein S, Hunerbein M, et al. Vessel-based non-rigid registration of MR/CT and 3D ultrasound for navigation in liver surgery. Comput Aided Surg. 2003;8:228–40.

    Article  PubMed  Google Scholar 

  11. Beller S, Hünerbein M, Lange T, et al. Image-guided surgery of liver metastases by 3D ultrasound based optoelectronic navigation. Br J Surg. 2007;94(7):866–75.

    Article  PubMed  CAS  Google Scholar 

  12. Munjuluri B, Huebschman ML, Garner HR. Rapid hologram updates for real-time volumetric information displays. Appl Opt. 2005;44:5076–85.

    Article  PubMed  Google Scholar 

  13. Grenacher L, Thorn M, Knaebel HP, et al. The role of 3-D imaging and computer-based postprocessing for surgery of the liver and pancreas. Rofo. 2005;177:1219–26.

    PubMed  CAS  Google Scholar 

  14. Chopra S, Hünerbein M, Eulenstein S et al. Development and validation of a three dimensional ultrasound based navigation system for tumor resection. Eur J Surg Oncol. 2007;34(4):456–61

    Google Scholar 

  15. Koulechov K, Strauss G, Dietz A, et al. FESS control: realization and evaluation of navigated control for functional endoscopic sinus surgery. Comput Aided Surg. 2006;11:147–59.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest statement

No financial or personal relationship with any organisation exists that could inappropriately bias this work.

Author information

Authors and Affiliations

  1. Surgery and Surgical Oncology, Charitè Universitätsmedizin Berlin, Experimental and Clinical Research Center (ECRC), Campus Berlin Buch, 13122, Berlin, Germany

    Siegfried Beller, Sebastian Eulenstein, Thomas Lange, Michael Hünerbein & Peter M. Schlag

Authors
  1. Siegfried Beller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sebastian Eulenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Hünerbein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter M. Schlag
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Siegfried Beller.

About this article

Cite this article

Beller, S., Eulenstein, S., Lange, T. et al. Upgrade of an optical navigation system with a permanent electromagnetic position control. J Hepatobiliary Pancreat Surg 16, 165–170 (2009). https://doi.org/10.1007/s00534-008-0040-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-008-0040-z

Keywords

Search

Navigation