A trial to visualize perforators images from CTA with a tablet device: experience of operating on minipigs

Figures & data

Figure 1. Components of the navigation system: a tablet device (iPad 2^® Apple Inc., CA, USA), CT-compatible markers, and plastic marker caps.

Figure 2. Screens during surgical navigation: the yellow object indicates a vascular structure. (a) Preoperative view of the tablet using a small triangle. Red and yellow crosses indicate perforator positions at the level of emergence from the fascia; (b) preoperative view of the tablet using a large triangle; (c) a 3D perforator image using a 3D slicer; (d) intraoperative view of the navigation system.

Figure 3. 3D vascular structures based on CT images. Based on the data, we selected perforators to be used in our experiment. (a) Lateral view; (b) dorsal view.

Table 1. Errors of tablet device navigation system registered by small and large triangles.

	Small triangle group	Large triangle group	p Value
Errors
In the direction of ventral form abdominal side
Max (mm)	6	20
Min (mm)	0	0
Mean ± SD (mm)	1.89 ± 1.91	4.67 ± 5.04	0.04
In the direction of head from caudal side
Max (mm)	10	8
Min (mm)	0	0
Mean ± SD (mm)	3.67 ± 3.41	2.78 ± 2.65	0.39
direct distance
Mean ± SD (mm)	4.33 ± 3.66	6.02 ± 5.02	0.26

Table 2. Coordination measured by optical tracking system (mm).

Errors	Target registration error (perforators)	Fiducial localization error
	(n = 6)	Marker 1 (n = 6)	Marker 2 (n = 6)	Marker 3 (n = 6)
Max (mm)	20.2	15.2	7.16	8.05
Min (mm)	2.08	1.51	1.12	0.15
Mean ± SD (mm)	10.8 ± 6.93	3.76 ± 5.07	2.38 ± 2.14	2.80 ± 2.33