Sebastian Bodenstedt1, Martin Wagner2, Benjamin Mayer2, Katherine Stemmer2, Hannes Kenngott2, Beat Müller-Stich2, Rüdiger Dillmann3, Stefanie Speidel4. 1. Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. bodenstedt@kit.edu. 2. Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. 3. Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. 4. Institute for Anthropomatics and Robotics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. speidel@kit.edu.
Abstract
PURPOSE: Minimally invasive interventions offer benefits for patients, while also entailing drawbacks for surgeons, such as the loss of depth perception. Thus estimating distances, which is of particular importance in gastric bypasses, becomes difficult. In this paper, we propose an approach based on stereo endoscopy that segments organs on-the-fly and measures along their surface during a minimally invasive interventions. Here, the application of determining the length of bowel segments during a laparoscopic bariatric gastric bypass is the main focus, but the proposed method can easily be used for other types of measurements, e.g., the size of a hernia. METHODS: As input, image pairs from a calibrated stereo endoscope are used. Our proposed method is then divided into three steps: First, we located structures of interest, such as organs and instruments, via random forest segmentation. Two modes of instrument detection are used. The first mode is based on an automatic segmentation, and the second mode uses input from the user. These regions are then reconstructed, and the distance along the surface of the reconstruction is measured. For measurement, we propose three methods. The first one is based on the direct distance of the instruments, while the second one finds the shortest path along a surface. The third method smooths the shortest path with a spline interpolation. Our measuring system is currently one shot, meaning a signal to begin a measurement is required. RESULTS: To evaluate our approach, data sets from multiple users were recorded during minimally invasive bowel measurements performed on phantoms and pigs. On the phantom data sets, the overall average error was [Formula: see text] on shorter pieces of bowel ([Formula: see text]5 cm) and [Formula: see text] on longer pieces ([Formula: see text]10 cm). On the porcine data sets, the average error was [Formula: see text]. CONCLUSION: We present and evaluate a novel approach that makes measuring on-the-fly during minimally invasive surgery possible. Furthermore, we compare different methods for determining the length of bowel segments. The only requirement for our approach is a calibrated stereo endoscope, thereby keeping the impact on the surgical workflow to a minimum.
PURPOSE: Minimally invasive interventions offer benefits for patients, while also entailing drawbacks for surgeons, such as the loss of depth perception. Thus estimating distances, which is of particular importance in gastric bypasses, becomes difficult. In this paper, we propose an approach based on stereo endoscopy that segments organs on-the-fly and measures along their surface during a minimally invasive interventions. Here, the application of determining the length of bowel segments during a laparoscopic bariatric gastric bypass is the main focus, but the proposed method can easily be used for other types of measurements, e.g., the size of a hernia. METHODS: As input, image pairs from a calibrated stereo endoscope are used. Our proposed method is then divided into three steps: First, we located structures of interest, such as organs and instruments, via random forest segmentation. Two modes of instrument detection are used. The first mode is based on an automatic segmentation, and the second mode uses input from the user. These regions are then reconstructed, and the distance along the surface of the reconstruction is measured. For measurement, we propose three methods. The first one is based on the direct distance of the instruments, while the second one finds the shortest path along a surface. The third method smooths the shortest path with a spline interpolation. Our measuring system is currently one shot, meaning a signal to begin a measurement is required. RESULTS: To evaluate our approach, data sets from multiple users were recorded during minimally invasive bowel measurements performed on phantoms and pigs. On the phantom data sets, the overall average error was [Formula: see text] on shorter pieces of bowel ([Formula: see text]5 cm) and [Formula: see text] on longer pieces ([Formula: see text]10 cm). On the porcine data sets, the average error was [Formula: see text]. CONCLUSION: We present and evaluate a novel approach that makes measuring on-the-fly during minimally invasive surgery possible. Furthermore, we compare different methods for determining the length of bowel segments. The only requirement for our approach is a calibrated stereo endoscope, thereby keeping the impact on the surgical workflow to a minimum.
Authors: Philip R Schauer; Sayeed Ikramuddin; Giselle Hamad; George M Eid; Samer Mattar; Dan Cottam; Ramesh Ramanathan; William Gourash Journal: J Laparoendosc Adv Surg Tech A Date: 2003-08 Impact factor: 1.878
Authors: Sebastian Rohl; Sebastian Bodenstedt; Stefan Suwelack; Rudiger Dillmann; Stefanie Speidel; Hannes Kenngott; Beat P Muller-Stich Journal: Med Phys Date: 2012-03 Impact factor: 4.071
Authors: L Maier-Hein; P Mountney; A Bartoli; H Elhawary; D Elson; A Groch; A Kolb; M Rodrigues; J Sorger; S Speidel; D Stoyanov Journal: Med Image Anal Date: 2013-05-03 Impact factor: 8.545
Authors: L Maier-Hein; A Groch; A Bartoli; S Bodenstedt; G Boissonnat; P-L Chang; N T Clancy; D S Elson; S Haase; E Heim; J Hornegger; P Jannin; H Kenngott; T Kilgus; B Müller-Stich; D Oladokun; S Röhl; T R Dos Santos; H-P Schlemmer; A Seitel; S Speidel; M Wagner; D Stoyanov Journal: IEEE Trans Med Imaging Date: 2014-05-23 Impact factor: 10.048
Authors: Martin Wagner; Benjamin Friedrich Berthold Mayer; Sebastian Bodenstedt; Katherine Stemmer; Arash Fereydooni; Stefanie Speidel; Rüdiger Dillmann; Felix Nickel; Lars Fischer; Hannes Götz Kenngott Journal: Surg Endosc Date: 2018-03-05 Impact factor: 4.584
Authors: Jean-Claude Rosenthal; Eric L Wisotzky; Carsten Matuschek; Melanie Hobl; Anna Hilsmann; Peter Eisert; Florian C Uecker Journal: HNO Date: 2021-10-11 Impact factor: 1.284
Authors: Jean-Claude Rosenthal; Eric L Wisotzky; Carsten Matuschek; Melanie Hobl; Anna Hilsmann; Peter Eisert; Florian C Uecker Journal: HNO Date: 2021-09-03 Impact factor: 1.284