BACKGROUND: Intraoperative image guidance during transoral robotic surgery (TORS) is hampered by imaging-friendly instrumentation and intraoperative positioning. The purpose of this study was to develop and validate an accurate image-guidance system for TORS. METHODS: A custom radiolucent mouth retractor was fabricated from biocompatible material (Med-610; Stratasys, Minneapolis, MN). Teflon beads were placed in the oropharynx and carotid arteries of 3 cadavers. CT scans were obtained in the preoperative and intraoperative positions. Displacement of targets between preoperative and intraoperative scans was measured. Surgical navigation was based on the open-source Image-Guided Surgery Toolkit. Target registration error (TRE) was determined by measuring the distance between the tracker and bead registered to preoperative versus intraoperative scans. RESULTS: The inferior oropharyngeal targets demonstrated the greatest displacement between positions. A significant reduction in TRE was observed when registering the tracker to the intraoperative compared to the preoperative scan. CONCLUSION: This study describes an accurate intraoperative image-guidance system for TORS.
BACKGROUND: Intraoperative image guidance during transoral robotic surgery (TORS) is hampered by imaging-friendly instrumentation and intraoperative positioning. The purpose of this study was to develop and validate an accurate image-guidance system for TORS. METHODS: A custom radiolucent mouth retractor was fabricated from biocompatible material (Med-610; Stratasys, Minneapolis, MN). Teflon beads were placed in the oropharynx and carotid arteries of 3 cadavers. CT scans were obtained in the preoperative and intraoperative positions. Displacement of targets between preoperative and intraoperative scans was measured. Surgical navigation was based on the open-source Image-Guided Surgery Toolkit. Target registration error (TRE) was determined by measuring the distance between the tracker and bead registered to preoperative versus intraoperative scans. RESULTS: The inferior oropharyngeal targets demonstrated the greatest displacement between positions. A significant reduction in TRE was observed when registering the tracker to the intraoperative compared to the preoperative scan. CONCLUSION: This study describes an accurate intraoperative image-guidance system for TORS.
Authors: Catherine H Davis; Miral S Grandhi; Victor P Gazivoda; Alissa Greenbaum; Timothy J Kennedy; Russell C Langan; H Richard Alexander; Henry A Pitt; David A August Journal: Surg Endosc Date: 2022-08-04 Impact factor: 3.453
Authors: Xiaotian Wu; David A Pastel; Rihan Khan; Clifford J Eskey; Yuan Shi; Michael Sramek; Joseph A Paydarfar; Ryan J Halter Journal: Ann Biomed Eng Date: 2022-01-07 Impact factor: 4.219