title: The implementation of an integrated computer-assisted system for minimally invasive cardiac surgery.
abstract: BACKGROUND
  Preoperative planning and surgical navigation are two crucial aspects of a computer-assisted system for the success of minimally invasive cardiac surgery.
  
  
  METHODS
  In the first part, port placement planning was mainly discussed. We proposed an algorithm based on four criteria to achieve optimized placement. In the second part, an optical tracker was used to locate the thoracoscope and surgical instruments accurately and to show the relative positions between the thoracoscope, surgical instruments and the patient's anatomical structures. An image-matching technique was employed to help the surgeon locate the target, using real-time thoracoscopic video images during the procedure.
  
  
  RESULTS
  In order to verify our proposed algorithms, several clinical planning cases were performed to compare our port placement algorithm to the traditional method. Both phantom test and animal study experiments were also done to demonstrate the validity of the target tracking of the system. Both the phantom test and the animal study revealed that the fiducial registration error (FRE) was 1.08 +/- 0.16 mm and system error was 5.05 +/- 0.67 mm, respectively.
  
  
  CONCLUSIONS
  A novel computer-assisted system for minimally invasive cardiac surgery has been developed. This method has shown its capability to achieve the preoperative planning and real-time surgery navigation.
authors.affiliation: Ruijing Hospital, Department of Cardiosurgery, 197 Rui Jin Er Road, Shanghai, People's Republic of China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Cai
authors.forename: Zhe
authors.initials: Z
authors.lastname: Luo
authors.forename: Lixu
authors.initials: L
authors.lastname: Gu
authors.forename: Rong
authors.initials: R
authors.lastname: Xu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
mesh_terms: D000465:Algorithms; D000818:Animals; D002138:Calibration; D006348:Cardiac Surgical Procedures / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D006321:Heart / Q000033:anatomy & histology; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D008954:Models, Biological; D015203:Reproducibility of Results; D012272:Ribs / Q000033:anatomy & histology; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D013552:Swine; D020708:Thoracoscopes; D013906:Thoracoscopy / Q000379:methods* / Q000592:standards; D014057:Tomography, X-Ray Computed