Patient-Specific Guides: Improved Point-Registration Accuracy for Surgical Navigation and Robotic-Assisted Surgery

Abstract

Image-based surgical navigation offers improved integration of preoperative planning with intraoperative execution and documentation. Registration is a fundamental step in all surgical navigation procedures and entails the alignment of preoperative image map with intraoperative physical anatomy. While implanted fiducial markers are the gold standard for registration, they either require an extra procedure or intraoperative imaging that add time and cost to the course of care. It is imperative to find an alternative that reduces the burden on patient, clinician, and the health care system. Paired-point matching using anatomic landmarks and surface mapping have been used as alternatives, but distinct landmarks or surfaces are needed for their effectiveness. A patient-specific point-registration guide was thus developed and evaluated for accuracy and precision in an idealized model. Results were encouraging and further work is recommended.