1,979 research outputs found
Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery
One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions
Augmented and virtual reality in surgery—the digital surgical environment:applications, limitations and legal pitfalls
The continuing enhancement of the surgical environment in the digital age has led to a number of innovations being highlighted as potential disruptive technologies in the surgical workplace. Augmented reality (AR) and virtual reality (VR) are rapidly becoming increasingly available, accessible and importantly affordable, hence their application into healthcare to enhance the medical use of data is certain. Whether it relates to anatomy, intraoperative surgery, or post-operative rehabilitation, applications are already being investigated for their role in the surgeons armamentarium. Here we provide an introduction to the technology and the potential areas of development in the surgical arena
Clinical Computing in Dentistry
Machines can seldom replace dentists in rightly handling the patients with optimistic human insight, considerations, creative planning and the monitoring of psychological acceptance and comfort experienced by any patient with the rehabilitation done. Intelligent computer related armamentarium with software can still help dental practitioners detect typical medical and dental signs and classify them according to certain rules more effectively. Based on image analysis algorithms, CAD systems can be used to look for signs of any tooth pathology that can be spotted in dental X-ray or cone beam computed tomography (CBCT) images. Applying computer vision algorithms to high-resolution CBCT slices helps to a great extent in diagnosing periapical lesions like granulomas, cysts, etc., and can help creating 3-D model of a root canal that reflects its shape with sufficient precision facilitating an optimum endodontic treatment planning. Hence, computer vision systems are already able to speed up the diagnostic process and provide a valuable second opinion in doubtful cases. This can lead a dentist and the patient thoroughly experience an optimistic acceptance and satisfaction of the treatment done
Algoritmos generales para simuladores de cirugía laparoscópica
Recent advances in fields such as modeling of deformable objects, haptic technologies, immersive technologies,
computation capacity and virtual environments have created the conditions to offer novel and suitable training tools and learning methods
in the medical area. One of these training tools is the virtual surgical simulator, which has no limitations of time or risk, unlike conventional
methods of training. Moreover, these simulators allow for the quantitative evaluation of the surgeon performance, giving the possibility to
create performance standards in order to define if the surgeon is well prepared to execute a determined surgical procedure on a real patient.
This paper describes the development of a virtual simulator for laparoscopic surgery. The simulator allows the multimodal
interaction between the surgeon and the surgical virtual environment using visual and haptic feedback devices. To make the
experience of the surgeon closer to the real surgical environment a specific user interface was developed. Additionally in this paper
we describe some implementations carried out to face typical challenges presented in surgical simulators related to the tradeoff
between real-time performance and high realism; for instance, the deformation of soft tissues are simulated using a GPU (Graphics
Processor Unit) -based implementation of the mass-spring model. In this case, we explain the algorithms developed taking into
account the particular case of a cholecystectomy procedure in laparoscopic surgery.Recientes avances en áreas tales como modelación computacional de objetos deformables, tecnologías hápticas, tecnologías
inmersivas, capacidad de procesamiento y ambiente virtuales han proporcionado las bases para el desarrollo de herramientas y métodos de
aprendizaje confiables en el entrenamiento médico. Una de estas herramientas de entrenamiento son los simuladores quirúrgicos virtuales,
los cuales no tienen limitaciones de tiempo o riesgos a diferencia de los métodos convencionales de entrenamiento. Además, dichos
simuladores permiten una evaluación cuantitativa del desempeño del cirujano, dando la posibilidad de crear estándares de desempeño con
el fin de definir en qué momento un cirujano está preparado para realizar un determinado procedimiento quirúrgico sobre un paciente.
Este artículo describe el desarrollo de un simulador virtual para cirugía laparoscópica. Este simulador permite la interacción
multimodal entre el cirujano y el ambiente virtual quirúrgico usando dispositivos de retroalimentación visual y háptica. Para hacer
la experiencia del cirujano más cercana a la de una ambiente quirúrgico real se desarrolló una interfaz cirujano-simulador especial.
Adicionalmente en este artículo se describen algunas implementaciones que solucionan los problemas típicos cuando se desarrolla un
simulador quirúrgico, principalmente relacionados con lograr un desempeño en tiempo real mientras se sacrifica el nivel de realismo
de la simulación: por ejemplo, la deformación de los tejidos blandos simulados usando una implementación del modelo masa-resorte
en la unidad de procesamiento gráfico. En este caso se describen los algoritmos desarrollados tomando en cuenta la simulación de un
procedimiento laparoscópico llamado colecistectomía
Microscope Embedded Neurosurgical Training and Intraoperative System
In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results.
In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point.
The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery.
This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient.
The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability.
Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery.
All the components are open source or at least based on a GPL license
Recent Developments and Future Challenges in Medical Mixed Reality
As AR technology matures, we have seen many applicationsemerge in entertainment, education and training. However, the useof AR is not yet common in medical practice, despite the great po-tential of this technology to help not only learning and training inmedicine, but also in assisting diagnosis and surgical guidance. Inthis paper, we present recent trends in the use of AR across all med-ical specialties and identify challenges that must be overcome tonarrow the gap between academic research and practical use of ARin medicine. A database of 1403 relevant research papers publishedover the last two decades has been reviewed by using a novel re-search trend analysis method based on text mining algorithm. Wesemantically identified 10 topics including varies of technologiesand applications based on the non-biased and in-personal cluster-ing results from the Latent Dirichlet Allocatio (LDA) model andanalysed the trend of each topic from 1995 to 2015. The statisticresults reveal a taxonomy that can best describes the developmentof the medical AR research during the two decades. And the trendanalysis provide a higher level of view of how the taxonomy haschanged and where the focus will goes. Finally, based on the valu-able results, we provide a insightful discussion to the current limi-tations, challenges and future directions in the field. Our objectiveis to aid researchers to focus on the application areas in medicalAR that are most needed, as well as providing medical practitioners with latest technology advancements
A Survey on the Current Status and Future Challenges Towards Objective Skills Assessment in Endovascular Surgery
Minimally-invasive endovascular interventions have evolved rapidly over the past decade, facilitated by breakthroughs in medical
imaging and sensing, instrumentation and most recently robotics. Catheter based operations are potentially safer and applicable to
a wider patient population due to the reduced comorbidity. As a result endovascular surgery has become the preferred treatment
option for conditions previously treated with open surgery and as such the number of patients undergoing endovascular interventions
is increasing every year. This fact coupled with a proclivity for reduced working hours, results in a requirement for efficient training
and assessment of new surgeons, that deviates from the “see one, do one, teach one” model introduced by William Halsted, so
that trainees obtain operational expertise in a shorter period. Developing more objective assessment tools based on quantitative
metrics is now a recognised need in interventional training and this manuscript reports the current literature for endovascular skills
assessment and the associated emerging technologies. A systematic search was performed on PubMed (MEDLINE), Google Scholar,
IEEXplore and known journals using the keywords, “endovascular surgery”, “surgical skills”, “endovascular skills”, “surgical training
endovascular” and “catheter skills”. Focusing explicitly on endovascular surgical skills, we group related works into three categories
based on the metrics used; structured scales and checklists, simulation-based and motion-based metrics. This review highlights the
key findings in each category and also provides suggestions for new research opportunities towards fully objective and automated
surgical assessment solutions
- …