How Insights from In Vivo Human Pilot Studies with da Vinci Image Guidance are Informing Next Generation System Design

Using an image guidance system constructed over the past several years [1], [2] we have recently collected our first in vivo human pilot study data on the use of the da Vinci for image guided partial nephrectomy [3]. Others have also previously created da Vinci image guidance systems (IGS) for various organs, using a variety of approaches [4]. Our system uses touch-based registration, in which the da Vinci’s tool tips lightly trace over the tissue surface and collect a point cloud. This point cloud is then registered to segmented medical images. We provide the surgeon a picture-in-picture 3D Slicer display, in which animated da Vinci tools move exactly as the real tools do in the endoscope view (see [2] for illustrations of this). The purpose of this paper is to discuss recent in vivo experiences and how they are informing future research on robotic IGS systems, particularly the use of ultrasound.