Patient Specific Pre-Operative Surgery Planning for Laparoscopic Surgery

Abstract

Minimal Invasive Surgery, (MIS), is an evolutionary approach in laparoscopic surgery that has been developed recently. In MIS, operations are performed by inserting instruments through small incisions and viewing using endo- scope. MIS techniques o er a new perspective to the surgeons. It di ers from standard surgery in three ways: visually, tactilely and interactively and this results in less pain and quicker recovery time. In MIS, there are certain disadvantages such as reduction of dexterity, limited workspace and sensory input through a single video image. Many companies and universities are working on pre-operative surgical planning simulator for di erent types of surgeries so that MIS is performed in a better and e cient way. These days, pre-operative surgical planning is becoming a common practice especially where a lot of e ort is required for performing laparoscopic surgery. Patient speci c pre-operative surgical planning tools play very important role in these environments. In this research, di erent pre-operative surgical planning methods have been surveyed. Surgical planning is needed in some cases like in neurosurgery, oral and maxillofacial surgery, and orthognathic surgery etc. Di erent pre- operative surgical planning software exist in market. Surgical planning is also needed in laparoscopic surgery for complex surgical procedure like acute cholecystectomy. It is due to the reason that ducts are hidden under several vii viii layers of fats. It is di cult for the surgeon to nd exact location of ducts and sometimes despite e orts, they failed to locate the desired organ and have to switch from MIS to conventional open surgery. For MIS, pre-operative surgery planning increases operational e ciency. Based on existing research, a method is proposed for pre-operative surgery planning of acute cholecystectomy. A CT scan is taken of a patient, su ering from acute cholecystitis. 3D patient speci c tetrahedral anatomical model is generated from the CT scan data. This model is loaded in Open Simulation Framework Architecture (SOFA) software and a complete simulation has been developed for acute cholecystitis surgery. When a surgeon wants to perform acute cholecystectomy, he can rst perform virtual surgery using our software.