Image guided surgery

Preliminary feasibility studies of frameless stereotactic liver surgery

Alan Joseph Herline, James D. Stefansic, Jacob P. Debelak, Steven L. Hartmann, C. Wright Pinson, Robert L. Galloway, William C. Chapman

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Background: Liver surgery can be difficult because there are few external landmarks defining hepatic anatomy and because the liver has significant vascularity. Although preoperative tomographic imaging (computed tomography or magnetic resonance imaging) provides essential anatomical information for operative planning, at present it cannot be used actively for precise localization during surgery. Interactive image-guided surgery involves the simultaneous real-time display of intraoperative instrument location on preoperative images (computed or positron-emission tomography or magnetic resonance imaging). Interactive image-guided surgery has been described for tumor localization in the brain (frameless stereotactic surgery) and allows for interactive use of preoperative images during resections or biopsies. Hypothesis: The application of interactive image- guided surgery (IIGS) is feasible for hepatic procedures from a biomedical engineering standpoint. Methods: We developed an interactive image-guided surgery system for liver surgery and tested a porcine liver model for tracking liver motion during insufflation; liver motion during respiration in open procedures in patients undergoing hepatic resection; and tracking accuracy of general surgical instruments, including a laparoscope and an ultrasound probe. Results: Liver motion due to insufflation can be quantified; average motion was 2.5 ± 1.4 min. Average total liver motion secondary to respiration in patients was 10.8 ± 2.5 mm. Instruments of varying lengths, including laparoscope, can be tracked to accuracies ranging from 1.4 to 2.1 mm within a 27-m3 (3 x 3 x 3-m) space. Conclusion: Interactive image-guided surgery appears to be feasible for open and laparoscopic hepatic procedures and may enhance future operative localization.

Original languageEnglish (US)
Pages (from-to)644-650
Number of pages7
JournalArchives of Surgery
Volume134
Issue number6
DOIs
StatePublished - Jan 1 1999

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Computer-Assisted Surgery
Feasibility Studies
Liver
Laparoscopes
Insufflation
Respiration
Magnetic Resonance Imaging
Biomedical Engineering
Surgical Instruments
Positron-Emission Tomography
Anatomy

ASJC Scopus subject areas

  • Surgery

Cite this

Herline, A. J., Stefansic, J. D., Debelak, J. P., Hartmann, S. L., Pinson, C. W., Galloway, R. L., & Chapman, W. C. (1999). Image guided surgery: Preliminary feasibility studies of frameless stereotactic liver surgery. Archives of Surgery, 134(6), 644-650. https://doi.org/10.1001/archsurg.134.6.644

Image guided surgery : Preliminary feasibility studies of frameless stereotactic liver surgery. / Herline, Alan Joseph; Stefansic, James D.; Debelak, Jacob P.; Hartmann, Steven L.; Pinson, C. Wright; Galloway, Robert L.; Chapman, William C.

In: Archives of Surgery, Vol. 134, No. 6, 01.01.1999, p. 644-650.

Research output: Contribution to journalArticle

Herline, AJ, Stefansic, JD, Debelak, JP, Hartmann, SL, Pinson, CW, Galloway, RL & Chapman, WC 1999, 'Image guided surgery: Preliminary feasibility studies of frameless stereotactic liver surgery', Archives of Surgery, vol. 134, no. 6, pp. 644-650. https://doi.org/10.1001/archsurg.134.6.644
Herline AJ, Stefansic JD, Debelak JP, Hartmann SL, Pinson CW, Galloway RL et al. Image guided surgery: Preliminary feasibility studies of frameless stereotactic liver surgery. Archives of Surgery. 1999 Jan 1;134(6):644-650. https://doi.org/10.1001/archsurg.134.6.644
Herline, Alan Joseph ; Stefansic, James D. ; Debelak, Jacob P. ; Hartmann, Steven L. ; Pinson, C. Wright ; Galloway, Robert L. ; Chapman, William C. / Image guided surgery : Preliminary feasibility studies of frameless stereotactic liver surgery. In: Archives of Surgery. 1999 ; Vol. 134, No. 6. pp. 644-650.
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