Stereoscopic augmented reality using ultrasound volume rendering for laparoscopic surgery in children

In laparoscopic surgery, live video provides visualization of the exposed organ surfaces in the surgical field, but is unable to show internal structures beneath those surfaces. The laparoscopic ultrasound is often used to visualize the internal structures, but its use is limited to intermittent confirmation because of the need for an extra hand to maneuver the ultrasound probe. Other limitations of using ultrasound are the difficulty of interpretation and the need for an extra port. The size of the ultrasound transducer may also be too large for its usage in small children. In this paper, we report on an augmented reality (AR) visualization system that features continuous hands-free volumetric ultrasound scanning of the surgical anatomy and video imaging from a stereoscopic laparoscope. The acquisition of volumetric ultrasound image is realized by precisely controlling a back-and-forth movement of an ultrasound transducer mounted on a linear slider. Furthermore, the ultrasound volume is refreshed several times per minute. This scanner will sit outside of the body in the envisioned use scenario and could be even integrated into the operating table. An overlay of the maximum intensity projection (MIP) of ultrasound volume on the laparoscopic stereo video through geometric transformations features an AR visualization system particularly suitable for children, because ultrasound is radiation-free and provides higher-quality images in small patients. The proposed AR representation promises to be better than the AR representation using ultrasound slice data.