Department of Biodesign, Institute of Biomaterial and Bioengineering, Tokyo Medical and Dental University



Ultrasound Navigation System for Fetal Surgery and WaFLES

Advancements in diagnostic technologies such as ultrasound imaging have enabled fetal diseases to be detected during the early stages of pregnancy. Therefore, research and clinical applications of fetal surgery for such diseases, which would otherwise lead to a stillbirth or severe birth defects, are now being developed. However, fetal surgery remains a very invasive treatment for both the fetus and the mother. Hence, we are trying to develop endoscopic fetal surgery techniques with an advanced supporting system for surgical procedures.

The most important problems in endoscopic fetal surgery are the limited field of view?due to the small viewfield and poor depth information on a 2D endoscope and the occasionally cloudy amniotic fluid?and the weak organs inside the uterus. The surgeon must therefore control the surgical instruments with great care and precision.

In light of these problems, we are developing a real-time updated navigation system using an intraoperative 3D ultrasound image for enhancing the surgeons' 3D viewfield and for enabling precise guidance of treatment. This project is a joint research with the National Center for Child Health and Development (NCCHD), Hitachi Aloka Medical Corp., and Innoventure-C Inc.

Fig. Navigation System using Intraoperative Real-time 3D Ultrasound Imaging

We are also trying to apply this navigation system to general laparoscopic surgery in order to establish a precise guidance environment with wide 3D information of the patient anatomy. Water-filled laparo-endoscopic surgery (WaFLES), a new concept of gasless laparoscopic surgery in which the abdominal cavity is filled with water, allows a patient’s body to be scanned using a 3D ultrasound probe from outside the body cavity. This is a joint research project with Prof. Tatsuo Igarashi.

Project WaFLES (CFME, Chiba Univ.)

Related publications

T.D. Pham, T. Igarashi, R. Nakamura,Surgical navigation system with fusing visualization of 3D ultrasound and CT image for water-filled laparo-endoscopic surgery, The 29th International Congress on Computer Assisted Radiology and Surgery (CARS2015), Barcelona, Spain, June 24-27, 2015, International Journal of Computer Assisted Radiology and Surgery, 10(suppl):S56-7, June 2015

Ikuma Sato, Ryoichi Nakamura, Evaluation of positioning error of GPU-based 3D ultrasound surgical navigation system for moving targets using optical tracking system, International Journal of Computer Assisted Radiology and Surgery, 8(3):379-393, May 2013

Ryo Otsuka, Ikuma Sato, Ryoichi Nakamura, GPU based real-time surgical navigation system with three-dimensional ultrasound imaging for water-filled laparo-endoscope surgery, The 34th Annual International Conference of the Engineering in Medicine and Biology Society (EMBC2012), San Diego, Aug. 28-Sept. 1, 2012, Proceedings pp.2800-2803

I. Sato, R. Nakamura, Real-time 3D ultrasound surgical navigation system showing high position accuracy for moving targets, 26th International Congress on Computer Assisted Radiology and Surgery (CARS2012), Pisa, Italy, June 27-30, 2012, Int J of CARS, 7(suppl1):S156-8, 2012

Ryoichi Nakamura, Gontaro Kitazumi, Ryoko Tanabe, Yasumasa Katsuike, Masamitsu Sudo, Takashi Mochizuki, Toshio Chiba, Real-time Updated Navigation System with 4D Ultrasound Imaging for Endoscopic Fetal Surgery, The 5th Asian Conference on Computer Aided Surgery (ACCAS2009), Chang Bin, Taiwan, July 3-4, 2009, abstract pp.109

Ryoichi Nakamura, Yuko Nagase, Masamitsu Sudo, Takashi Mochizuki, Yoshihiro Muragaki, Hiroshi Iseki, Ichiro Sakuma, and Toshio Chiba, 4D ultrasound navigation system for endoscopic fetal surgery with sound alarming, Int J CARS, 3(suppl1):255, 2008