A fluorolaser navigation system to guide linear surgical tool insertion

Jack T. Liang, Takehito Doke, Shinya Onogi, Satoru Ohashi, Isao Ohnishi, Ichiro Sakuma, Yoshikazu Nakajima

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Purpose Conventional navigation systems for minimally invasive orthopedic surgery require a secondary monitor to display guidance information generated with CT or MRI images. Newer systems use augmented reality to project surgical plans into binocular glasses. These surgical procedures are often mentally challenging and cumbersome to perform. Method A comprehensive surgical navigation system for direct guidance while minimizing radiation exposure was designed and built. System accuracy was evaluated using in vitro needle insertion experiments. The fluoroscopic-based navigation technique is combined with an existing laser guidance technique. As a result, the combined system is capable of surgical planning using two or more X-ray images rather than CT or MRI scans. Guidance information is directly projected onto the patient using two laser beams and not via a secondary monitor. Results We performed 15 in vitro needle insertion experiments as well as 6 phantom pedicle screw insertion experiments to validate navigation system accuracy. The planning accuracy of the system was found to be 2.32mm and 2.28̊, while its overall guidance accuracy was found to be 2.40mm and 2.39̊. System feasibility was demonstrated by successfully performing percutaneous pin insertion on phantoms. Conclusion Quantitative and qualitative evaluations of the fluorolaser navigation system show that it can support accurate guidance and intuitive surgical tool insertion procedures without preoperative 3Dimage volumes and registration processes.

Original languageEnglish
Pages (from-to)931-939
Number of pages9
JournalInternational Journal of Computer Assisted Radiology and Surgery
Issue number6
Publication statusPublished - Nov 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Computer Vision and Pattern Recognition
  • Health Informatics
  • Computer Science Applications
  • Computer Graphics and Computer-Aided Design


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