ABSTRACT
Purpose: To study the difference between rigid registration and nonrigid registration using two forms of digitization (contact and noncontact) in human in vivo liver surgery. Approach: A Conoprobe device attachment and sterilization process was developed to enable prospective noncontact intraoperative acquisition of organ surface data in the operating room (OR). The noncontact Conoprobe digitization method was compared against stylus-based acquisition in the context of image-to-physical registration for image-guided surgical navigation. Data from n=10 patients undergoing liver resection were analyzed under an Institutional Review Board-approved study at Memorial Sloan Kettering Cancer Center. Organ surface coverage of each surface acquisition method was compared. Registration accuracies resulting from the acquisition techniques were compared for (1) rigid registration method (RRM), (2) model-based nonrigid registration method (NRM) using surface data only, and (3) NRM with one subsurface feature (vena cava) from tracked intraoperative ultrasound (NRM-VC). Novel vessel centerline and tumor targets were segmented and compared to their registered preoperative counterparts for accuracy validation. Results: Surface data coverage collected by stylus and Conoprobe were 24.6%±6.4% and 19.6%±5.0%, respectively. The average difference between stylus data and Conoprobe data using NRM was -1.05 mm and using NRM-VC was -1.42 mm, indicating the registrations to Conoprobe data performed worse than to stylus data with both NRM approaches. However, using the stylus and Conoprobe acquisition methods led to significant improvement of NRM-VC over RRM by average differences of 4.48 and 3.66 mm, respectively. Conclusion: The first use of a sterile-field amenable Conoprobe surface acquisition strategy in the OR is reported for open liver surgery. Under clinical conditions, the nonrigid registration significantly outperformed standard-of-care rigid registration, and acquisition by contact-based stylus and noncontact-based Conoprobe produced similar registration results. The accuracy benefits of noncontact surface acquisition with a Conoprobe are likely obscured by inferior data coverage and intrinsic noise within acquisition systems.
ABSTRACT
Fretting is a phenomenon that occurs at the contacts of surfaces that are subjected to oscillatory relative movement of small amplitudes. Depending on service conditions, fretting may significantly reduce the service life of a component due to fretting fatigue. In this regard, the analysis of stresses at contact is of great importance for predicting the lifetime of components. However, due to the complexity of the fretting phenomenon, analytical solutions are available for very selective situations and finite element (FE) analysis has become an attractive tool to evaluate stresses and to study fretting problems. Recent laboratory studies in fretting fatigue suggested the presence of stress singularities in the stick-slip zone. In this paper, we constructed finite element models, with different element sizes, in order to verify the existence of stress singularity under fretting conditions. Based on our results, we did not find any singularity for the considered loading conditions and coefficients of friction. Since no singularity was found, the present paper also provides some comments regarding the convergence rate. Our analyses showed that the convergence rate in stress components depends on coefficient of friction, implying that this rate also depends on the loading condition. It was also observed that errors can be relatively high for cases with a high coefficient of friction, suggesting the importance of mesh refinement in these situations. Although the accuracy of the FE analysis is very important for satisfactory predictions, most of the studies in the literature rarely provide information regarding the level of error in simulations. Thus, some recommendations of mesh sizes for those who wish to perform FE analysis of fretting problems are provided for different levels of accuracy.
