Improving Surgical Situational Awareness with Signed Distance Field: A Pilot Study in Virtual Reality

The introduction of image-guided surgical navigation (IGSN) has greatly benefited technically demanding surgical procedures by providing real-time support and guidance to the surgeon during surgery. \hi{To develop effective IGSN, a careful selection of the surgical information and the medium to present this information to the surgeon is needed. However, this is not a trivial task due to the broad array of available options.} To address this problem, we have developed an open-source library that facilitates the development of multimodal navigation systems in a wide range of surgical procedures relying on medical imaging data. To provide guidance, our system calculates the minimum distance between the surgical instrument and the anatomy and then presents this information to the user through different mechanisms. The real-time performance of our approach is achieved by calculating Signed Distance Fields at initialization from segmented anatomical volumes. Using this framework, we developed a multimodal surgical navigation system to help surgeons navigate anatomical variability in a skull base surgery simulation environment. Three different feedback modalities were explored: visual, auditory, and haptic. To evaluate the proposed system, a pilot user study was conducted in which four clinicians performed mastoidectomy procedures with and without guidance. Each condition was assessed using objective performance and subjective workload metrics. This pilot user study showed improvements in procedural safety without additional time or workload. These results demonstrate our pipeline's successful use case in the context of mastoidectomy.Comment: First two authors contributed equally. 6 page

Robot-Assisted Deep Venous Thrombosis Ultrasound Examination using Virtual Fixture

Deep Venous Thrombosis (DVT) is a common vascular disease with blood clots inside deep veins, which may block blood flow or even cause a life-threatening pulmonary embolism. A typical exam for DVT using ultrasound (US) imaging is by pressing the target vein until its lumen is fully compressed. However, the compression exam is highly operator-dependent. To alleviate intra- and inter-variations, we present a robotic US system with a novel hybrid force motion control scheme ensuring position and force tracking accuracy, and soft landing of the probe onto the target surface. In addition, a path-based virtual fixture is proposed to realize easy human-robot interaction for repeat compression operation at the lesion location. To ensure the biometric measurements obtained in different examinations are comparable, the 6D scanning path is determined in a coarse-to-fine manner using both an external RGBD camera and US images. The RGBD camera is first used to extract a rough scanning path on the object. Then, the segmented vascular lumen from US images are used to optimize the scanning path to ensure the visibility of the target object. To generate a continuous scan path for developing virtual fixtures, an arc-length based path fitting model considering both position and orientation is proposed. Finally, the whole system is evaluated on a human-like arm phantom with an uneven surface.Comment: Accepted Paper IEEE T-AS