Augmented Reality with Diffusion Tensor Imaging 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 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 preoperative imaging and fusing it in real-time with the endoscopic image. Magnetic resonance diffusion tensor imaging (DTI) and fiber tractography are known to provide additional information to that obtained from standard structural magnetic resonance imaging (MRI). Here, we report the first 2 cases of the use of real-time augmented reality during laparoscopic myomectomies with visualization of uterine muscle fibers after DTI tractography–MRI to help the surgeon decide the starting point incision.In the first case, a 31-year-old patient was undergoing laparoscopic surgery for a 6-cm FIGO type V myoma. In the second case, a 38-year-old patient was undergoing a laparoscopic myomectomy for a unique 6-cm FIGO type VI myoma. Signed consent forms were obtained from both patients, which included clauses of no modification of the surgery. Before surgery, MRI was performed. The external surface of the uterus, the uterine cavity, and the surface of the myomas were delimited on the basis of the findings of preoperative MRI. A fiber tracking algorithm was used to extrapolate the u...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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