Intraoperative Imaging and Navigation in Robotic Surgery

• Published in: Atlas of Head and Neck Robotic Surgery pp. 201 - 213
• Main Author: Liu, Wen P.
• Format: Book Chapter
• Language: English
• Published: Switzerland Springer International Publishing AG 2017; Springer International Publishing
• Subjects: Augmented Video; Cone Beam Computed Tomography (CBCT); Intraoperative CBCT; Primary Visual Field; SURGERY; Transoral Robotic Surgery (TORS)
• ISBN: 3319495763; 9783319495767
• DOI: 10.1007/978-3-319-49578-1_20

Robotic surgery requires intraoperative precision and three-dimensional spatial understanding of the surgical target and its surrounding anatomy. Although the magnification and stereo capabilities of current minimally invasive robotic surgery provide high-resolution views of the surgical field, tactile feedback is diminished or absent due to tele-manipulation, which increases the surgeon’s reliance on visual cues. Furthermore, a loss of orientation or localization adds to the inherent risks of breaching critical structures, especially in the hands of inexperienced surgeons. Multimodal imaging provides visualization of critical anatomic structures reviewed during diagnostic and preoperative planning (Abdullah et al. Ann Acad Med, Singapore 32:442–445, 2003; Sahani et al. Radiographics 24:1367–1380, 2004; Ozsarlak et al. Eur Radiol 13:2338–2345, 2003). However, during the surgical procedure, preoperative images are generally viewed on an external monitor (Cheng et al. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 26:796–798, 2012), and the correlation of these images with the patient’s anatomy is left as a mental exercise. As such, the accuracy of this practice is highly dependent on the surgeon’s experience and is therefore subject to inconsistencies, especially when surgeons must anticipate surgical strategy beyond the current endoscopic field of view. The emergence of robotic surgery has therefore accentuated a gap that currently exists between correlating medical imaging and visualizing anatomy in surgical navigation.