Image-guided laparoscopic surgery in an open MRI operating theater.
BACKGROUND
The recent development of open magnetic resonance imaging (MRI) has provided an opportunity for the next stage of image-guided surgical and interventional procedures. The purpose of this study was to evaluate the feasibility of laparoscopic surgery under the pneumoperitoneum with the system of an open MRI operating theater.


METHODS
Five patients underwent laparoscopic surgery with a real-time augmented reality navigation system that we previously developed in a horizontal-type 0.4-T open MRI operating theater.


RESULTS
All procedures were performed in an open MRI operating theater. During the operations, the laparoscopic monitor clearly showed the augmented reality models of the intraperitoneal structures, such as the common bile ducts and the urinary bladder, as well as the proper positions of the prosthesis. The navigation frame rate was 8 frames per min. The mean fiducial registration error was 6.88 ± 6.18 mm in navigated cases. We were able to use magnetic resonance-incompatible surgical instruments out of the 5-Gs restriction area, as well as conventional laparoscopic surgery, and we developed a real-time augmented reality navigation system using open MRI.


CONCLUSIONS
Laparoscopic surgery with our real-time augmented reality navigation system in the open MRI operating theater is a feasible option.
Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. tnori@surg2.med.kyushu-u.ac.jp
Norifumi
N
Tsutsumi
Morimasa
M
Tomikawa
Munenori
M
Uemura
Tomohiko
T
Akahoshi
Yoshihiro
Y
Nagao
Kozo
K
Konishi
Satoshi
S
Ieiri
Jaesung
J
Hong
Yoshihiko
Y
Maehara
Makoto
M
Hashizume
D062788:Adenomyosis / Q000601:surgery; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D041761:Cholecystolithiasis / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D061646:Operative Time; D011028:Pneumoperitoneum, Artificial; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome