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This limits the use of surgical image-guidance technologies and challenges the appropriate placement of trocars, which influences the operative ease and potential quality of laparoscopic surgery. This work describes the development of a platform that simulates pneumoperitoneum in a patient-specific manner, using preoperative CT scans as input data. This aims to provide a more realistic representation of the intraoperative scenario and guide trocar positioning to optimize the ergonomics of laparoscopic instrumentation. The simulation was developed by generating 3D reconstructions of insufflated and deflated porcine CT scans and simulating an artificial pneumoperitoneum on the deflated model. Simulation parameters were optimized by minimizing the discrepancy between the simulated pneumoperitoneum and the ground truth model extracted from insufflated porcine scans. Insufflation modeling in humans was investigated by correlating the simulation\u2019s output to real post-insufflation measurements obtained from patients in theatre. The simulation returned an average error of 7.26\u00a0mm and 10.5\u00a0mm in the most and least accurate datasets respectively. In context of the initial discrepancy without simulation (23.8\u00a0mm and 19.6\u00a0mm), the methods proposed here provide a significantly improved picture of the intraoperative scenario. The framework was also demonstrated capable of simulating pneumoperitoneum in humans. This study proposes a method for realistically simulating pneumoperitoneum to achieve optimal ergonomics during laparoscopy. Although further studies to validate the simulation in humans are needed, there is the opportunity to provide a more realistic, interactive simulation platform for future image-guided minimally invasive surgery.<\/jats:p>","DOI":"10.1007\/s10916-019-1441-z","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T20:03:40Z","timestamp":1568145820000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Patient-Specific Simulation of Pneumoperitoneum for Laparoscopic Surgical Planning"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3091-2305","authenticated-orcid":false,"given":"Shivali","family":"Dawda","sequence":"first","affiliation":[]},{"given":"Mafalda","family":"Camara","sequence":"additional","affiliation":[]},{"given":"Philip","family":"Pratt","sequence":"additional","affiliation":[]},{"given":"Justin","family":"Vale","sequence":"additional","affiliation":[]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[]},{"given":"Erik","family":"Mayer","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"1441_CR1","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1007\/s00276-010-0763-9","volume":"33","author":"FM S\u00e1nchez-Margallo","year":"2011","unstructured":"S\u00e1nchez-Margallo, F. 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All applicable international, national, and\/or institutional guidelines for the care and use of animals were followed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"317"}}