computer-aided renal punctures

Passive guidance for computer-aided renal punctures

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Percutaneous access to the kidney is used for biopsies or for destruction of stones. It is performed under fluoroscopic (radiating) or echographic (difficult) control. We have developed a passive guiding system based on a 3D/3D US/CT rigid registration. Planning is done from two fused pre-operative CT scans (early and late injection). Localized echographic data are collected intra-operatively. After registration, the needle trajectory is optically tracked and guided passively. Due to motion of the kidney with breathing, this approach requires having the patient under apnoea for the echographic acquisition and for the guidance. A first version based on surface registration requires intra-operative segmentation of the US data whilst the second version is segmentation-less.

References:

- Mozer P. Urologie et GMCAO, Medicine Thesis, Paris VI, 2003

- Leroy A., Mozer P., Payan Y., Richard F., Chartier-Kastler E., Troccaz J. Percutaneous renal puncture: requirements and preliminary results. n Proceedings of Surgetica’2002, Troccaz J., Merloz P. 5eds), Sauramps Medical, 2002, pp303-309

Collaborations: La Pitié-Salpétrière, Hospital, Paris (Dr Mozer, Pr Chartier-Kastler – urology dept) – PRAXIM-Medivision

Status: Validation of the version including surface based registration and guidance on anatomical parts and cadavers, validation of the registration modula (surface and voxel-based) on data of a healthy volunteer. On-going evolutions and industrial project. One thesis defended in 2004; one on-going thesis (clinical side).

Contact : jocelyne.troccaz@imag.fr or yohan.payan@imag.fr


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