AR visualization of "synthetic Calot's triangle" for training in cholecystectomy

The most challenging step of cholecystectomy is the identification of Calot’s triangle. Adequate training by the surgical operators may reduce intraoperative risks due to anatomical misinterpretation. In this context, augmented reality (AR) can offer an excellent contribution to traditional education, by allowing the implementation of hybrid simulators featuring the visualization of hidden anatomical structures. The aim of this study is to evaluate whether a complete AR visualization of the Calot’s triangle is possible by means of a commercial electromagnetic tracking system and a limited number of sensors. A strategy for the manufacturing and sensorization of the Calot’s triangle, is proposed. Sensorized replica of the most common configurations of the arterial tree and biliary tree were fabricated by using seven electromagnetic coils. Accuracy in AR visualization was preliminarily evaluated in quantitative and qualitative terms. Obtained results confirmed the feasibility of the proposed AR approach to track and visualize the Calot’s triangle. The achieved accuracy is adequate for training purposes and can be employed to aid the trainee in the recognition of the Calot's triangle. Based on these results, the developed prototypes will be integrated into our cholecystectomy simulator for a complete assessment.