Dynamic 3-D Virtual Fixtures for Minimally Invasive Beating Heart Procedures

Two-dimensional or 3-D visual guidance is often used for minimally invasive cardiac surgery and diagnosis. This visual guidance suffers from several drawbacks such as limited field of view, loss of signal from time to time, and in some cases, difficulty of interpretation. These limitations become more evident in beating-heart procedures when the surgeon has to perform a surgical procedure in the presence of heart motion. In this paper, we propose dynamic 3-D virtual fixtures (DVFs) to augment the visual guidance system with haptic feedback, to provide the surgeon with more helpful guidance by constraining the surgeon´s hand motions thereby protecting sensitive structures. DVFs can be generated from preoperative dynamic magnetic resonance (MR) or computed tomograph (CT) images and then mapped to the patient during surgery. We have validated the feasibility of the proposed method on several simulated surgical tasks using a volunteer´s cardiac image dataset. Validation results show that the integration of visual and haptic guidance can permit a user to perform surgical tasks more easily and with reduced error rate. We believe this is the first work presented in the field of virtual fixtures that explicitly considers heart motion.