Advanced Endoscopic Navigation:Surgical Big Data,Methodology,and Applications

随着科学技术的飞速发展，健康与环境问题日益成为人类面临的最重大问题之一。信息科学、计算机技术、电子工程与生物医学工程等学科的综合应用交叉前沿课题，研究现代工程技术方法，探索肿瘤癌症等疾病早期诊断、治疗和康复手段。本论文综述了计算机辅助微创外科手术导航、多模态医疗大数据、方法论及其临床应用：从引入微创外科手术导航概念出发，介绍了医疗大数据的术前与术中多模态医学成像方法、阐述了先进微创外科手术导航的核心流程包括计算解剖模型、术中实时导航方案、三维可视化方法及交互式软件技术，归纳了各类微创外科手术方法的临床应用。同时，重点讨论了全球各种手术导航技术在临床应用中的优缺点，分析了目前手术导航领域内的最新技术方法。在此基础上，提出了微创外科手术方法正向数字化、个性化、精准化、诊疗一体化、机器人化以及高度智能化的发展趋势。【Abstract】Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.X.L. acknowledges funding from the Fundamental Research Funds for the Central Universities. T.M.P. acknowledges funding from the Canadian Foundation for Innovation, the Canadian Institutes for Health Research, the National Sciences and Engineering Research Council of Canada, and a grant from Intuitive Surgical Inc

Laparoscopic treatment of type III and IV hiatal hernia : authors' experience

INTRODUCTION: There are four types of hiatal hernias, and diagnosis is established on the basis of gastroscopy in the majority of cases. Type III represents a mixed type in which the abdominal esophagus as well as the gastric cardia and fundus protrude into the thorax through the pathologically widened esophageal hiatus. Type IV, the so-called upside down stomach, can be considered an evolutionary form of type III, and refers to herniation of nearly the whole stomach (except for the cardia and pylorus) into the thorax. Types III and IV of hiatal hernias represent a group of rare diaphragmatic defects; thus, most centers do not possess considerable experience in their treatment. Frequently, laparoscopic treatment is implemented, although, according to some authors, conversion to laparotomy, thoracotomy, or thoracolaparotomy is necessary in selected cases. AIM: To analyze the outcomes of laparoscopic treatment of the largest hiatal hernias, i.e. type III and IV hernias. MATERIAL AND METHODS: A total of 25 patients diagnosed with type III and IV hiatal hernia were included in further analysis. RESULTS: As many as 19 out of 25 patients (76%) assessed the outcome of the surgery as evidently positive and reported marked improvement in the quality of life. CONCLUSIONS: The laparoscopic technique constitutes an excellent and safe method of repair of even the most complex defects in the esophageal hiatus. Therefore, the minimally invasive technique combined with an anti-reflux procedure should be the method of choice in patients with type III and IV hernia

Evaluation of Grazing Techniques as a Nutrition Source for Horses in a Pasture Environment

Horses require daily access to forage in order to support their gastrointestinal tract function as well as natural grazing behaviors. Well-managed pasture provides horses with a consistent forage source and diminishes health risks such as colic, ulcers and stereotypies. However, equine grazing behaviors are more intense than other livestock and may be detrimental to plant and soil health. A grazing management technique specifically for horses is necessary to prevent both health and environmental issues. The following dissertation explores both the movement of required maintenance elements, such as feed, shelter, and water, as well as the manipulation of feeding frequency and mechanism to deliberately distribute equine activities within an equine pasture environment. Both considerations were evaluated via Global Positioning System units to determine location within respect to feed, shelter and water and scan-sampling to categorize grazing and non-grazing behaviors. It was determined that frequent movement of the feeding element may also distribute horse activities accordingly and become an efficient pasture management technique. Feeding frequency and mechanism was found to also distribute equine location with the most influential component being manual, twice daily feeding of a concentrated hay balancer

Building up the Future of Colonoscopy – A Synergy between Clinicians and Computer Scientists

Recent advances in endoscopic technology have generated an increasing interest in strengthening the collaboration between clinicians and computers scientist to develop intelligent systems that can provide additional information to clinicians in the different stages of an intervention. The objective of this chapter is to identify clinical drawbacks of colonoscopy in order to define potential areas of collaboration. Once areas are defined, we present the challenges that colonoscopy images present in order computational methods to provide with meaningful output, including those related to image formation and acquisition, as they are proven to have an impact in the performance of an intelligent system. Finally, we also propose how to define validation frameworks in order to assess the performance of a given method, making an special emphasis on how databases should be created and annotated and which metrics should be used to evaluate systems correctly