Augmented reality guidance with electromagnetic tracking for Transpyloric tube insertion

Transpyloric tube insertion is a commonly intervention which consists in inserting a tube through the nose, the oesophagus and the stomach until the pylorus. This procedure can be done blindly if no licensed physician operator is available. Thus, the caregivers have to insert the tube without any visual feedbacks. The position of the tube has also to be conformed to avoid any issues. We proposed a guidance system for the insertion of this tube through an augmented reality application using an electromagnetic tracker. The trajectory and the orientation of the tube were visualized on a screen to monitor the tube insertion but also to conform the position of the tube tip inside the pylorus. This monitoring was improved by adding preoperative landmarks coming from a CT image or intraoperative landmarks obtained with ultrasound. Finally, the display was overlaid on a camera view to match the tube trajectory on the patient during the insertion so the clinicians directly visualized anatomical landmarks to guide themselves during the tube insertion. Preliminary results on one phantom showed the usefulness of our guidance system for blindly tube insertion. Further evaluations have to be realized on animals and on patients to validate these results.