Noeska Smit, Kai Lawonn, Annelot Kraima, Marco de Ruiter, Hessam Sokooti, Stefan Bruckner, Elmar Eisemann, Anna Vilanova
Short Description
This image depicts PelVis [1], an interactive application for surgical planning for the Total Mesorectal Excision (TME) procedure. During this surgical procedure, undesired side-effects occur in up to 80% of the cases due to damage to the autonomic nerves. These nerves are damaged easily, since they are not visible in pre-operative MRI or even during the surgery. In order to visualize these nerves, we built an atlas model, the Virtual Surgical Pelvis (VSP) [1], that reveals zones in which the autonomic nerves reside based on cryosection and immunohistochemical studies. In the PelVis application, we register this atlas to patient-specific clinical MRI data and thus are able to make patient-specific virtual models of the individual patient, and to reveal the autonomic nerve zones pre-operatively, as displayed here in yellow. We highlight the distance of the mesorectal wall to these nerve zones using a colormap (red to white) combined with isolines. Furthermore, other surgically relevant anatomy is shown for spatial context, without occluding the view on the mesorectum, and the linked atlas-enriched MRI data can be explored interactively [3].
[1]: Smit, N., Lawonn, K., Kraima, A., DeRuiter, M., Sokooti, H., Bruckner, S., … & Vilanova, A. PelVis: Atlas-based Surgical Planning for Oncological Pelvic Surgery. (2017) IEEE Transactions on Visualization & Computer Graphics, (1), 1-1. Accepted, to appear.
[2]: Kraima, A., Smit, N. N., Jansma, D., West, N. P., Quirke, P., Rutten, H. J., … & DeRuiter, M. C. (2014). 62. The virtual surgical pelvis: A highly-detailed 3D pelvic model for anatomical education and surgical simulation. European Journal of Surgical Oncology, 40(11), S32.