Global Laparoscopy Positioning System with a Smart Trocar

Purpose: in the context of minimally invasive surgery, navigation in the patients abdomen is crucial, but is also more complicated than during open procedures. While the advantages for the patient are numerous, surgeons may not always know where they are in this complex environment, and getting used to this technique takes a lot of practice. Method: we present a novel smart trocar device that provides a global positioning system for the laparoscopic instruments that are inserted through the trocars. We augment current trocars with a camera pointing towards the ceiling. At any point in time, and by using computer vision as well as projective geometry, our smart trocar can provide the position of rigid instruments. Results: with our system, we reach one-millimeter accuracy on translation and half a degree on rotation with the only limitation being the velocity of surgeons movements. But this limitation has not been an obstacle in real practice. Conclusion: the trocar can track specific landmarks found on the ceiling of the OR, and, from these, accurately determine its global position in the OR in real time. Applications of this invention are first, assessment and/or training of surgical skills second, once our system is coupled to a real-time three-dimensional simulator of patient anatomy, we envision that our system can automatically provide surgical guidance during the procedure.