title: Clinical application of a surgical navigation system based on virtual laparoscopy in laparoscopic gastrectomy for gastric cancer.
abstract: OBJECTIVE
  Knowledge of the specific anatomical information of a patient is important when planning and undertaking laparoscopic surgery due to the restricted field of view and lack of tactile feedback compared to open surgery. To assist this type of surgery, we have developed a surgical navigation system that presents the patient's anatomical information synchronized with the laparoscope position. This paper presents the surgical navigation system and its clinical application to laparoscopic gastrectomy for gastric cancer.
  
  
  METHODS
  The proposed surgical navigation system generates virtual laparoscopic views corresponding to the laparoscope position recorded with a three-dimensional (3D) positional tracker. The virtual laparoscopic views are generated from preoperative CT images. A point-based registration aligns coordinate systems between the patient's anatomy and image coordinates. The proposed navigation system is able to display the virtual laparoscopic views using the registration result during surgery.
  
  
  RESULTS
  We performed surgical navigation during laparoscopic gastrectomy in 23 cases. The navigation system was able to present the virtual laparoscopic views in synchronization with the laparoscopic position. The fiducial registration error was calculated in all 23 cases, and the average was 14.0 mm (range 6.1-29.8).
  
  
  CONCLUSIONS
  The proposed surgical navigation system can provide CT-derived patient anatomy aligned to the laparoscopic view in real time during surgery. This system enables accurate identification of vascular anatomy as a guide to vessel clamping prior to total or partial gastrectomy.
authors.affiliation: Information & Communications, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan. yhayashi@mori.m.is.nagoya-u.ac.jp.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.affiliation: Graduate School of Information Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8603, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Oda
authors.affiliation: Information Technology Center, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.|Centre for Medical Image Computing, University College London, Gower Street, London, WC1E 6BT, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hawkes
authors.affiliation: Information & Communications, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.|Graduate School of Information Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8603, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
keywords: Gastric cancer; Laparoscopic gastrectomy; Laparoscopy; Stomach; Surgical navigation; Virtual laparoscopy