Abstract

Conventional navigation systems used in transsphenoidal pituitary surgery have limitations that may lead to organ damage, including long image registration time, absence of alarms when approaching vital organs and lack of 3-D model information. To resolve the problems of conventional navigation systems, this study proposes a U-Net-based, automatic segmentation algorithm for optical nerves and internal carotid arteries, by training patient computed tomography angiography images. The authors have also developed a bendable endoscope and surgical tool to eliminate blind regions that occur when using straight, rigid, conventional endoscopes and surgical tools during transsphenoidal pituitary surgery. In this study, the effectiveness of a U-Net-based navigation system integrated with bendable surgical tools and a bendable endoscope has been demonstrated through phantom-based experiments. In order to measure the U-net performance, the Jaccard similarity, recall and precision were calculated. In addition, the fiducial and target registration errors of the navigation system and the accuracy of the alarm warning functions were measured in the phantom-based environment.

Highlights

  • We were were able able to to conclude conclude that that the the proposed proposed surgical surgical navigation navigation system system in in this this study study was was as as or more accurate than conventional surgical navigation systems [32,33,34,35]

  • Experimental results indicated that U-Net surgery developed by applying U-Net and bendable devices

  • Experimental results indicated that Uwas for internal carotid arteries (ICAs)

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Summary

Introduction

This method of operation involves approaching the pituitary tumor through the shortest path—by incising the nasal septum and removing the rostrum bone. When a microscope is used, no obstacle can intrude between the surgical space and the microscope. This meant that it was necessary to remove more of the body structure than was necessary. To secure the surgical space view, TSA surgery using an endoscope has been developed [1,2,3]

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