A surgical robot with augmented reality visualization for stereoelectroencephalography electrode implantation

Abstract

Purpose

Using existing stereoelectroencephalography (SEEG) electrode implantation surgical robot systems, it is difficult to intuitively validate registration accuracy and display the electrode entry points (EPs) and the anatomical structure around the electrode trajectories in the patient space to the surgeon. This paper proposes a prototype system that can realize video see-through augmented reality (VAR) and spatial augmented reality (SAR) for SEEG implantation. The system helps the surgeon quickly and intuitively confirm the registration accuracy, locate EPs and visualize the internal anatomical structure in the image space and patient space.

Methods

We designed and developed a projector-camera system (PCS) attached to the distal flange of a robot arm. First, system calibration is performed. Second, the PCS is used to obtain the point clouds of the surface of the patient's head, which are utilized for patient-to-image registration. Finally, VAR is produced by merging the real-time video of the patient and the preoperative three-dimensional (3D) operational planning model. In addition, SAR is implemented by projecting the planning electrode trajectories and local anatomical structure onto the patient's scalp.

Results

The error of registration, the electrode EPs and the target points are evaluated on a phantom. The fiducial registration error is \(0.25 \pm 0.23\) mm (max 1.22 mm), and the target registration error is \(0.62\pm 0.28\) mm (max 1.18 mm). The projection overlay error is \(0.75\pm 0.52\) mm, and the TP error after the pre-warped projection is \(0.82\pm 0.23\) mm. The TP error caused by a surgeon's viewpoint deviation is also evaluated.

Conclusion

The presented system can help surgeons quickly verify registration accuracy during SEEG procedures and can provide accurate EP locations and internal structural information to the surgeon. With more intuitive surgical information, the surgeon may have more confidence and be able to perform surgeries with better outcomes.

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