Augmented Reality with Diffusion Tensor Imaging (DTI) and Tractography during laparoscopic myomectomies

Publication date: Available online 22 November 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Pauline Chauvet, Nicolas Bourdel, Lilian Calvet, Benoit Magnin, Guillaume Teluob, Michel Canis, Adrien BartoliAbstractAugmented reality (AR) is a technology that allows a surgeon to see key hidden subsurface structures in an endoscopic video in real time. This works by overlaying information obtained from pre-operative imaging, and fusing it in real time with the endoscopic image. MR-DTI and fiber tractography are known to provide additional information to standard structural MRI. Here we report the first two cases of real-time augmented reality during laparoscopic myomectomies with visualization of uterine muscle fibers after DTI tractography-MRI, to help the surgeon to decide the starting point incision.First case: A 31 years-old patient underwent a laparoscopic surgery for a 6cm FIGO 5 myoma. Second case: a 38 years-old patient also underwent a laparoscopic myomectomy, for a unique 6cm myoma FIGO 6. Signed consents were obtained for all the patients, which included clauses of no modification of the surgery. Before surgery, MRI were realized. The external surface of the uterus, the uterine cavity, and the surface of the myomas were delimited according to the preoperative MRI. A fiber tracking algorithm was used to extrapolate the uterine muscle fibers architecture.The aligned models were blended with each video frame to give the feeling that the uterus is almost tra...

Source: Journal of Minimally Invasive Gynecology - November 22, 2019 Category: OBGYN Source Type: research