Nicolas Bourdel1, Toby Collins2, Daniel Pizarro2, Clement Debize2, Anne-Sophie Grémeau3, Adrien Bartoli2, Michel Canis4. 1. Department of Gynecologic Surgery, Centre Hospitalier de l'Université Estaing Clermont-Ferrand, Clermont-Ferrand, France; ALCoV, Image Science for Interventional Techniques (Unité Mixte de Recherche 6284, Centre National de la Recherche Scientifique), University of Auvergne, Clermont-Ferrand, France. Electronic address: micolas.bourdel@gmail.com. 2. ALCoV, Image Science for Interventional Techniques (Unité Mixte de Recherche 6284, Centre National de la Recherche Scientifique), University of Auvergne, Clermont-Ferrand, France. 3. Department of Gynecologic Surgery, Centre Hospitalier de l'Université Estaing Clermont-Ferrand, Clermont-Ferrand, France. 4. Department of Gynecologic Surgery, Centre Hospitalier de l'Université Estaing Clermont-Ferrand, Clermont-Ferrand, France; ALCoV, Image Science for Interventional Techniques (Unité Mixte de Recherche 6284, Centre National de la Recherche Scientifique), University of Auvergne, Clermont-Ferrand, France.
Abstract
OBJECTIVE: To report the use of augmented reality (AR) in gynecology. DESIGN: AR is a surgical guidance technology that enables important hidden surface structures to be visualized in endoscopic images. AR has been used for other organs, but never in gynecology and never with a very mobile organ like the uterus. We have developed a new AR approach specifically for uterine surgery and demonstrated its use for myomectomy. SETTING: Tertiary university hospital. PATIENT(S): Three patients with one, two, and multiple myomas, respectively. INTERVENTION(S): AR was used during laparoscopy to localize the myomas. MAIN OUTCOME MEASURE(S): Three-dimensional (3D) models of the patient's uterus and myomas were constructed before surgery from T2-weighted magnetic resonance imaging. The intraoperative 3D shape of the uterus was determined. These models were automatically aligned and "fused" with the laparoscopic video in real time. RESULT(S): The live fused video made the uterus appear semitransparent, and the surgeon can see the location of the myoma in real time while moving the laparoscope and the uterus. With this information, the surgeon can easily and quickly decide on how best to access the myoma. CONCLUSION(S): We developed an AR system for gynecologic surgery and have used it to improve laparoscopic myomectomy. Technically, the software we developed is very different to approaches tried for other organs, and it can handle significant challenges, including image blur, fast motion, and partial views of the organ.
OBJECTIVE: To report the use of augmented reality (AR) in gynecology. DESIGN: AR is a surgical guidance technology that enables important hidden surface structures to be visualized in endoscopic images. AR has been used for other organs, but never in gynecology and never with a very mobile organ like the uterus. We have developed a new AR approach specifically for uterine surgery and demonstrated its use for myomectomy. SETTING: Tertiary university hospital. PATIENT(S): Three patients with one, two, and multiple myomas, respectively. INTERVENTION(S): AR was used during laparoscopy to localize the myomas. MAIN OUTCOME MEASURE(S): Three-dimensional (3D) models of the patient's uterus and myomas were constructed before surgery from T2-weighted magnetic resonance imaging. The intraoperative 3D shape of the uterus was determined. These models were automatically aligned and "fused" with the laparoscopic video in real time. RESULT(S): The live fused video made the uterus appear semitransparent, and the surgeon can see the location of the myoma in real time while moving the laparoscope and the uterus. With this information, the surgeon can easily and quickly decide on how best to access the myoma. CONCLUSION(S): We developed an AR system for gynecologic surgery and have used it to improve laparoscopic myomectomy. Technically, the software we developed is very different to approaches tried for other organs, and it can handle significant challenges, including image blur, fast motion, and partial views of the organ.