Surgical tool alignment by laser guidance using fluoroscopic-based navigation technique: A system implementation and validation study

This paper provides a novel method for intuitive and CT-less surgical navigation based on fluoroscopic-based navigation and laser guidance technology for minimal invasive orthopaedic surgery. This method does not require intra-operative registration of three-dimensional surface model derived from pre-operative CT/MRI volumes and is able to project surgical path planed intra-operatively onto the patient's skin directly. In this paper, implementation of this method and basic in vitro guidance accuracy validation were performed. Tool insertion path planning was performed on three 2D images from a pinhole imaging source taken at different incident angles. A 3D insertion pathway was generated and projected using two laser beams. Our Fluorolaser system has a planning accuracy of 1.07±0.60 mm, 0.73±0.38 degrees and an overall guidance accuracy of 1.11±0.62 mm, 0.80±0.68 degrees. These results demonstrate that the proposed method has great potentials to ensure accurate and intuitive surgical procedures.