Software-assisted live visualization system for subjacent blood vessels in endonasal endoscopic approaches

Minimal invasive surgery methods have received growing attention in recent years. In vital important areas, it is crucial for the surgeon to have a precise knowledge of the tissue structure. Especially the visualization of arteries is desirable, as the destruction of the same can be lethal to the patient. In order to meet this requirement, the study presents a novel assistance system for endoscopic surgery. While state-of-the art systems rely on pre-operational data like computer-tomographic maps and require the use of radiation, the goal of the presented approach is to provide the clarification of subjacent blood vessels on live images of the endoscope camera system. Based on the transmission and reflection spectra of various human tissues, a prototype system with a NIR illumination unit working at 808 nm was established. Several image filtering, processing and enhancement techniques have been investigated and evaluated on the raw pictures in order to obtain high quality results. The most important were increasing contrast and thresholding by difference of Gaussian method. Based on that, it is possible to rectify a fragmented artery pattern and extract geometrical information about the structure in terms of position and orientation. By superposing the original image and the extracted segment, the surgeon is assisted with valuable live pictures of the region of interest. The whole system has been tested on a laboratory scale. An outlook on the integration of such a system in a clinical environment and obvious benefits are discussed.