Fetoscopic Panorama Reconstruction: Moving from Ex-vivo to In-vivo

Twin-to-Twin Transfusion Syndrome (TTTS) is a condition that occurs in about 10% of pregnancies involving monochorionic twins. This complication can be treated with fetoscopic laser coagulation. The procedure could greatly benefit from panorama reconstruction to gain an overview of the placenta. Current state-of-the-art methods focus on panorama reconstruction in an ex-vivo setting. However, these methods fail in the in-vivo surgical setting. This paper describes the panorama reconstruction approach, the challenges posed by the in-vivo setting and the influence of these challenges on the panorama reconstruction. With experiments we show that the viewing quality is greatly reduced and that the limited motion of the fetoscope complicates and limits the precision of the image registration. We also identify the aspect necessary to shift from ex-vivo to in-vivo panorama reconstruction. Following our recommendations it should be possible to develop an approach that can be applied to TTTS surgery.