Marker-Based Registration for Large Deformations - Application to Open Liver Surgery

This paper introduces an Augmented Reality (AR) system for open liver surgery. Although open surgery remains the gold-standard for the treatment of complex tumors and central lesions, technological issues actually prevent using AR with sufficient accuracy for clinical use. We propose a markers-based method allowing for the tracking and the deformation of a preoperative model in real-time during the surgery. Markers are manually placed on the surface of the organ after opening the abdominal cavity, and tracked in real-time by a set of infrared cameras. Our framework is composed of both a nonrigid initial registration method, providing an estimation of the location of the markers in the preoperative model, and a realtime tracking algorithm to deform the model during the surgery (even for large deformation or partial occlusion of the organ). The method is validated on both synthetic and ex-vivo samples; in addition, we demonstrate its applicability in the operating room during a liver resection surgery on a human patient. Preliminary studies provided promising results to improve the location of tumors, and to help surgeons into planning the ideal resection intraoperatively.