Use of augmented reality in laparoscopic gynecology to visualize myomas

We developed an augmented reality system for laparoscopic gynecology, in which the uterus appears semitransparent and the surgeon can see myomas in real time while moving the laparoscope and the uterus.

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Volume 107, Issue 3, Pages 737–739

Authors:

Nicolas Bourdel, M.D., Toby Collins, Ph.D., Daniel Pizarro, Ph.D., Clement Debize, Anne-sophie Grémeau, M.D., Adrien Bartoli, Ph.D., Michel Canis, M.D., Ph.D.

Abstract:

Objective

To report the use of augmented reality (AR) in gynecology.

Design

AR is a surgical guidance technology that enables important hidden surface structures to be visualized in endoscopic images. AR has been used for other organs, but never in gynecology and never with a very mobile organ like the uterus. We have developed a new AR approach specifically for uterine surgery and demonstrated its use for myomectomy.

Setting

Tertiary university hospital.

Patient(s)

Three patients with one, two, and multiple myomas, respectively.

Intervention(s)

AR was used during laparoscopy to localize the myomas.

Main Outcome Measure(s)

Three-dimensional (3D) models of the patient's uterus and myomas were constructed before surgery from T2-weighted magnetic resonance imaging. The intraoperative 3D shape of the uterus was determined. These models were automatically aligned and “fused” with the laparoscopic video in real time.

Result(s)

The live fused video made the uterus appear semitransparent, and the surgeon can see the location of the myoma in real time while moving the laparoscope and the uterus. With this information, the surgeon can easily and quickly decide on how best to access the myoma.

Conclusion(s)

We developed an AR system for gynecologic surgery and have used it to improve laparoscopic myomectomy. Technically, the software we developed is very different to approaches tried for other organs, and it can handle significant challenges, including image blur, fast motion, and partial views of the organ.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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