Extemporaneous route planning during live endoscopic surgical procedures

A method for automatically computing a new guidance route extemporaneously through a hollow organ system of a patient to a previously unplanned region of interest (ROI) observed during a live endoscopic procedure performed by a physician, the method comprising the steps of:

• loading planning information computed offline prior to the live endoscopic procedure into a guidance system, the planning information representing the hollow organ system, centerlines within the organ system, and a preplanned guidance route leading to a preselected ROI, based on a three-dimensional (3D) radiologic image of the patient, wherein the centerlines consist of a set of directed paths pi, with each path pi consisting of a set of view sites visited once and only once along the path, originating at a beginning branch of the hollow organ system and terminating at a distal hollow organ branch;
• loading image sources of the patient, the image sources including the 3D radiologic image, other 3D radiologic images, and endoscopic video generated during the live endoscopic procedure;
• providing graphical tools constituting the guidance system's visual display, the graphical tools depicting various visualizations of the patient, based on the image sources;
• navigating the endoscope to the preselected ROI along the preplanned guidance route;
• identifying the previously unplanned ROI on one of the graphical tools of the visual display while navigating the endoscope to the preselected ROI;
• automatically correlating a site of the previously unplanned ROI identified on the one of the graphical tools representing the previously unplanned ROI to the centerlines of the planning information to give a closest view site vc to the previously unplanned ROI;
• automatically computing a new guidance route through the hollow organ system leading to the previously unplanned ROI, based on the closest view site vc, the previously unplanned ROI, planning information, and image sources, comprising the steps of:
• i. selecting a path pi containing the view site vc among the set of directed paths;
• ii. computing a new guidance route leading to the previously unplanned ROI, based on path pi;
• and
• navigating the endoscope along the new guidance route through the hollow organ system to reach the previously unplanned ROI.