Real-Time 3D Visualization and Navigation Using Fiber-Based Endoscopic System for Arthroscopic Surgery

Three-dimensional (3D) navigation using a computer-assisted technique is being increasingly performed in minimally invasive surgical procedures because it can provide stereoscopic information regarding the operating field to the surgeon. In this paper, the development of a real-time arthroscopic system utilizing an endoscopic camera and optical fiber to navigate a normal vector for a reconstructed knee joint surface is described. A specific navigation approach suitable for use in a rendered surface was presented in extenso. A small-sized endoscopic tube was utilized arthroscopically on a cadaveric knee joint to show the potential application of the developed system. Experimental results of underwater navigation on a synthetic knee joint showed that our system allows for a higher accuracy than a freehand technique. The mean angle of navigation for the proposed technique is 9.5 circ (range, 5 circ to 17 circ ; SD, 2.86 circ ) versus 14.8 circ (range, 6 circ to 26 circ ; SD, 7.53 circ ) and 12.6 circ (range, 4 circ to 17 circ ; SD, 3.98 circ ) for two sites using a freehand technique.