Initial image-plane assessment of kinematic-based stereo overlay in trans-oral robotic surgery

Abstract

Positive surgical margins are a common complication of trans-oral tumor resection, and implementation of image guidance is typically hindered by significant tissue deformation introduced by oral retractors. Recent advances have produced multiple pathways for developing intraoperative trans-oral image guidance, which must ultimately be displayed to the surgeon in real time. This work presents a pipeline for automatically displaying CT-registered three-dimensional surface structures in the surgeon console of a da Vinci surgical system, and assesses image-plane projection accuracy using Dice coefficient and intersection over union metrics. While coarse accuracy is acceptable (metric averages > 0.5), more accurate projections were obtained using registration methods based on optically tracking the endoscope shaft. Further improvement of registration, kinematic modeling, and endoscope calibration is necessary prior to use in preclinical evaluation of image guidance strategies for trans-oral robotic surgery.