Computer-Assisted Laparoscopic myomectomy by augmenting the uterus with pre-operative MRI data

An active research objective in Computer Assisted Intervention (CAI) is to develop guidance systems to aid surgical teams in laparoscopic Minimal Invasive Surgery (MIS) using Augmented Reality (AR). This involves registering and fusing additional data from other modalities and overlaying it onto the laparoscopic video in realtime. We present the first AR-based image guidance system for assisted myoma localisation in uterine laparosurgery. This involves a framework for semi-automatically registering a pre-operative Magnetic Resonance Image (MRI) to the laparoscopic video with a deformable model. Although there has been several previous works involving other organs, this is the first to tackle the uterus. Furthermore, whereas previous works perform registration between one or two laparoscopic images (which come from a stereo laparoscope) we show how to solve the problem using many images (e.g. 20 or more), and show that this can dramatically improve registration. Also unlike previous works, we show how to integrate occluding contours as registration cues. These cues provide powerful registration constraints and should be used wherever possible. We present retrospective qualitative results on a patient with two myomas and quantitative semi-synthetic results. Our multi-image framework is quite general and could be adapted to improve registration in other organs with other modalities such as CT.