Integrated MR-laparoscopy system with respiratory synchronization for minimally invasive liver surgery

Abstract

Purpose: The laparoscope has been invaluable in minimally invasive surgery, but provides only a surface view of target tissue; therefore it is lacking internal tissue information. In combination with the laparoscope for visualizing the cross-sectional view of the tissue, MRI is superior to ultrasonography or X-ray CT, because of its high soft-tissue contrast, arbitrary slice orientation and lack of radiation properties. Thus, we propose an integrated MR-laparoscopy system with a respiratory-synchronized navigation. Methods: A transmit/receive RF coil for localized MR imaging with a 0.5 T open-MRI was mounted onto the tip of an MR-compatible laparoscope. The signal detection of the coil was examined with an excised porcine liver sample, an agar phantom and the abdominal wall of a healthy volunteer. A real-time navigation system to compensate for respiratory motion was developed, and examined with a healthy volunteer. Results: The SNRs of the local MR images were 112, 62, and 62 in the liver sample, phantom, and volunteer. The navigation system successfully displayed the scope view, scope location and orientation, and MR images with respiratory-synchronized real time operation. Conclusions: The MR-imaging and synchronization function of the proposed system seemed to be helpful for laparoscopic surgery. © Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2009.