Image-guided navigation system for minimally invasive total hip arthroplasty (MITHA) using an improved position-sensing marker

Distributed visual positioning for surgical instrument tracking

In clinical operations, it is crucial for surgeons to know the location of the surgical instrument. Traditional positioning systems have difficulty dealing with camera occlusion, marker occlusion, and environmental interference. To address these issues, we propose a distributed visual positioning system for surgical instrument tracking in surgery. First, we design the marker pattern with a black and white triangular grid and dot that can be adapted to various instrument surfaces and improve the marker location accuracy of the feature. The cross-points in the marker are the features that each feature has a unique ID. Furthermore, we proposed detection and identification for the position-sensing marker to realize the accurate location and identification of features. Second, we introduce multi Perspective-n-Point (mPnP) method, which fuses feature coordinates from all cameras to deduce the final result directly by the intrinsic and extrinsic parameters. This method provides a reliable initial value for the Bundle Adjustment algorithms. During instrument tracking, we assess the motion state of the instrument and select either dynamic or static Kalman filtering to mitigate any jitter in the instrument's movement. The core algorithms comparison experiment indicates our positioning algorithm has a lower reprojection error comparison to the mainstream algorithms. A series of quantitative experiments showed that the proposed system positioning error is below 0.207 mm, and the run time is below 118.842 ms. The results demonstrate the tremendous clinical application potential of our system providing accurate positioning of instruments promoting the efficiency and safety of clinical surgery.

Intraoperative Angle Measurement of Anatomical Structures: A Systematic Review

Ensuring precise angle measurement during surgical correction of orientation-related deformities is crucial for optimal postoperative outcomes, yet there is a lack of an ideal commercial solution. Current measurement sensors and instrumentation have limitations that make their use context-specific, demanding a methodical evaluation of the field. A systematic review was carried out in March 2023. Studies reporting technologies and validation methods for intraoperative angular measurement of anatomical structures were analyzed. A total of 32 studies were included, 17 focused on image-based technologies (6 fluoroscopy, 4 camera-based tracking, and 7 CT-based), while 15 explored non-image-based technologies (6 manual instruments and 9 inertial sensor-based instruments). Image-based technologies offer better accuracy and 3D capabilities but pose challenges like additional equipment, increased radiation exposure, time, and cost. Non-image-based technologies are cost-effective but may be influenced by the surgeon's perception and require careful calibration. Nevertheless, the choice of the proper technology should take into consideration the influence of the expected error in the surgery, surgery type, and radiation dose limit. This comprehensive review serves as a valuable guide for surgeons seeking precise angle measurements intraoperatively. It not only explores the performance and application of existing technologies but also aids in the future development of innovative solutions.