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In robot-assisted endoscopic nasal surgery, due to the slender and complicated nasal cavity and sinus anatomical structure, the nasal endoscope of robot end-effector is prone to injure surrounding tissues during surgical approaches. In order to improve the movement safety of the endoscope in robot-assisted endoscopic nasal surgery, a path planning method for endoscopic surgical approaches based on medical image pixel map searching is proposed in this paper, and safe surgical paths from the nasal entrance point to the operating areas are obtained. Firstly, through the trajectory analysis of nasal endoscope tip during surgery, the path planning requirements of endoscope tip are analyzed and obtained. Then, considering the slender and complicated anatomy of the nasal cavity, a binarized three-dimensional grid map containing the spatial anatomy of the nasal cavity is constructed based on the patient's CT medical image sequence. The endoscopic surgical approaches are searched and optimized by introducing the A-star algorithm, and safe surgical paths from the nasal entrance point to the operating areas are obtained. Finally, a virtual nasal endoscopy system is developed and tested on a head model containing nasal tissue, and the effectiveness of the planned surgical paths is verified by automatic virtual nasal endoscopy browsing experiment.

Background: The advent of both high-resolution computed tomographic (CT) imaging and minimally invasive endoscopic techniques has led to revolutionary advances in sinus surgery. However, the rhinologist is left to make the conceptual jump between static cross-sectional images and the anatomy encountered intraoperatively. A three-dimensional (3D) visuo-haptic representation of the patient's anatomy may allow for enhanced preoperative planning and rehearsal, with the goal of improving outcomes, decreasing complications, and enhancing technical skills. Methods: We developed a novel method of automatically constructing 3D visuo-haptic models of patients' anatomy from preoperative CT scans for placement in a virtual surgical environment (VSE). State-of-the-art techniques were used to create a high-fidelity representation of salient bone and soft tissue anatomy and to enable manipulation of the virtual patient in a surgically meaningful manner. A modified haptic interface device drives a virtual endoscope that mimics the surgical configuration. Results: The creation and manipulation of sinus anatomy from CT data appeared to provide a relevant means of exploring patient-specific anatomy. Unlike more traditional methods of interacting with multiplanar imaging data, our VSE provides the potential for a more intuitive experience that can replicate the views and access expected at surgery. The inclusion of tactile (haptic) feedback provides an additional dimension of realism. Conclusion: The incorporation of patient-specific clinical CT data into a virtual surgical environment holds the potential to offer the surgeon a novel means to prepare for rhinologic procedures and offer training to residents. An automated pathway for segmentation, reconstruction, and an intuitive interface for manipulation may enable rehearsal of planned procedures. [ABSTRACT FROM AUTHOR]