三维重建结合增强现实技术在机器人下精准肝切除术中的应用

摘要/Abstract

达芬奇机器人在肝脏外科领域的应用已被证实是安全可行的，但无法透视肝内重要管道和精准定位肝实质内肿瘤。虚拟现实和增强现实等技术的应用可使人体结构立体化、可视化，术前三维模型的建立可以帮助医生制定完善的术前规划，增强现实的应用可以实时进行术中指导，从而避免损伤肝内重要管道，减少出血，并保证安全的手术切缘。本文报道了 2 例达芬奇机器人肝脏手术，在三维重建结合增强现实技术的指导下进行了精准的肝切除。

The Da Vinci robot surgical procedure has been proved to be safe and feasible in the field of liver surgery, but it still has the shortage of being unable to penetrate important hepatic ducts and accurately locate tumors in liver parenchyma. The application of technologies such as virtual reality and augmented reality can make the human body structure three-dimensional and visualized. The establishment of a three-dimensional model before surgery can help us make better preoperative planning, the application of augmented reality can provide real-time intraoperative guidance to avoid damage to important intrahepatic ducts, reduce intraoperative hemorrhage, and ensure safe surgical margins. This article reports two cases of Da Vinci liver surgery, which was accurately performed under the guidance of 3D reconstruction combined with augmented reality technology.

稿件信息

参考文献

[1] CHEN W, ZHENG R, Baade P D, et al.Cancer statistic in China, 2015[J].CA Cancer J Clin, 2016, 66 (2): 115- 132.

[2] Buchs N C, Volonte F, François Pugin, et al.Augmented environments for the targeting of hepatic lesions during image-guided robotic liver surgery[J].Journal of Surgical Research, 2013, 184 (2): 825-831.

[3] 朱呈瞻 , 董冰子 , 席跃 , 等 . 机器人辅助与传统腹腔镜肝切除术的效果比较 [J]. 腹腔镜外科杂志 , 2018, 23 (12): 7-10.

[4] 王壮雄 , 李林容 , 王芳元 , 等 . 虚拟和增强现实技术在肝脏外科中的应用 [J]. 实用医学杂志 , 2018, 34 (7): 172-174.

[5] Marescaux J, Rubino F, Arenas M, et al.Augmentedrealityassisted laparoscopic adrenalectomy[J].Journal of the American Medical Association, 2004, 292 (18): 2214-2215.

[6] Su L M, Vagvolgyi B P, Agarwal R, et al.Augmented Reality During Robot-assisted Laparoscopic Partial Nephrectomy: Toward Real-Time 3D-CT to Stereoscopic Video Registration[J].Urology, 2009, 73 (4): 896-900.

[7] Pessaux P, Diana M, Soler L, et al.Towards cybernetic surgery: Robotic and augmented reality-assisted liver segmentectomy[J]. Langenbeck’s Archives of Surgery, 2015, 400 (3): 381-385.

[8] 方驰华 , 张鹏 , 罗火灵 , 等 . 增强现实导航技术联合吲哚菁绿分子荧光影像在三维腹腔镜肝切除术中的应用 [J]. 中华外科杂志 , 2019, 57 (8): 578-584.

[9] Ayoub A, Pulijala Y.The application of virtual reality and augmented reality in Oral and Maxillofacial Surgery[J].BMC Oral Health, 2019, 19 (1): 238-246.

[10] Kim Y, Kim H, Kim Y O.Virtual Reality and Augmented Reality in Plastic Surgery: A Review[J]. Archives of Plastic Surgery, 2017, 44 (3): 179-187.

[11] Jae-Hak Kim, Adrien Bartoli, Toby Collins, et al.Tracking by detection for interactive image augmentation in laparoscopy.Proceedings of the 5th International Conference on Biomedical Image Registration (WBIR 2012)

[M].New York USA: Springer-Verlag, 2012: 246- 255.

[12] Puerto-Souza G A, Mariottini G L.Wide-Baseline Dense Feature Matching for Endoscopic Images

[M].Pacific Rim Symposium on Image and Video Technology: Springer, Berlin, Heidelberg, 2013: 48-59.

[13] Haouchine N, Cotin S, Peterlik I, et al.Impact of Soft Tissue Heterogeneity on Augmented Reality for Liver Surgery[J].IEEE Transactions on Visualization and Computer Graphics, 2015, 21 (5): 584-597.

[14] Kenngott H G, Wagner M, Gondan M, et al.Real-time image guidance in laparoscopic liver surgery: first clinical experience with a guidance system based on intraoperative CT imaging[J].Surg Endosc, 2014, 28 (3): 933-940.

[0]	综合治疗神经内分泌寡转移前列腺癌一例报道
[1]	三维重建结合增强现实技术在机器人下精准肝切除术中的应用
[2]	达芬奇机器人与胸腔镜在肺癌淋巴结整块清扫中的对比研究
[3]	机器人单孔腹腔镜手术在妇科领域的应用进展
[4]	三维影像重建技术辅助机器人手术系统在宫颈癌根治术中的应用
[5]	Si 级达芬奇机器人辅助单孔腹腔镜与普通单孔腹腔镜在早期子宫内膜癌治疗中的对照研究
[6]	达芬奇机器人手术系统行妇科手术 606 例临床分析
[7]	达芬奇机器人系统在复杂性子宫肌瘤剔除术中的应用