Virtually transparent surgical instruments in endoscopic surgery with augmentation of obscured regions

Yuta Koreeda, Yo Kobayashi, Satoshi Ieiri, Yuya Nishio, Kazuya Kawamura, Satoshi Obata, Ryota Souzaki, Makoto Hashizume, Masakatsu G. Fujie

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Purpose: We developed and evaluated a visual compensation system that allows surgeons to visualize obscured regions in real time, such that the surgical instrument appears virtually transparent. Methods: The system consists of two endoscopes: a main endoscope to observe the surgical environment, and a supporting endoscope to render the region hidden from view by surgical instruments. The view captured by the supporting endoscope is transformed to simulate the view from the main endoscope, segmented to the shape of the hidden regions, and superimposed to the main endoscope image so that the surgical instruments look transparent. A prototype device was benchmarked for processing time and superimposition rendering error. Then, it was evaluated in a training environment with 22 participants performing a backhand needle driving task with needle exit point error as the criterion. Lastly, we conducted an in vivo study. Results: In the benchmark, the mean processing time was 62.4 ms, which was lower than the processing time accepted in remote surgeries. The mean superimposition error of the superimposed image was 1.4 mm. In the training environment, needle exit point error with the system decreased significantly for experts compared with the condition without the system. This change was not significant for novices. In the in vivo study, our prototype enabled visualization of needle exit points during anastomosis. Conclusion: The benchmark suggests that the implemented system had an acceptable performance, and evaluation in the training environment demonstrated improved surgical task outcomes in expert surgeons. We will conduct a more comprehensive in vivo study in the future.

Original languageEnglish
Pages (from-to)1927-1936
Number of pages10
JournalInternational Journal of Computer Assisted Radiology and Surgery
Issue number10
Publication statusPublished - Oct 1 2016

All Science Journal Classification (ASJC) codes

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


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