Visualization of anatomical information in near-infrared imaging for robotic urological surgery

Commercial telerobotic surgery systems for soft tissue surgery are generally limited to visual imaging, though it is possible to simultaneously view picture-in-picture visualization of another workstation. However, it is not easy to correlate such information with the primary endoscopic view since it may not relate to the surface visible in the visual endoscopic images. As critical surfaces as well as surgical targets often lie subsurface, a range of techniques (e.g. ultrasound and near-infrared imaging) and registration methods have been investigated as robotic surgery gains popularity. While investigation of nerves, blood vessels, and tumors has received prior attention, we present a new prototype system for real-time multimodal image registration that focuses on the visualization of the urinary tract. By providing an accurate registration between stereo video images and a near infrared imager, we aim to enhance surgical awareness and make critical uretary tasks such as mobilization of the ureters easier. Engineering validation experiments with a prototype imager, and in-vivo experiments using a prototype Hamamatsu Photodynamic Eye (PDE) imager together with the da Vinci surgical system demonstrating feasibility are presented. These initial experiments have also shown encouraging response from the clinicians.