Advanced Augmented Reality Telestration Techniques With Applications In Laparoscopic And Robotic Surgery

The art of teaching laparoscopic or robotic surgery currently has a primary reliance on an expert surgeon tutoring a student during a live surgery. During these operations, surgeons are viewing the inside of the body through a manipulatable camera. Due to the viewpoint translation and narrow field of view, these techniques have a substantial learning curve in order to gain the mastery necessary to operate safely. In addition to moving and rotating the camera, the surgeon must also manipulate tools inserted into the body. These tools are only visible on camera, and pass through a pivot point on the body that, in non-robotic cases, reverses their directions of motion when compared to the surgeon\u27s hands. These difficulties spurred on this dissertation. The main hypothesis of this research is that advanced augmented reality techniques can improve telementoring for use between expert surgeons and surgical students. In addition, it can provide a better method of communication between surgeon and camera operator. This research has two specific aims: (1) Create a head-mounted direction of focus indicator to provide non-verbal assistance for camera operation. A system was created to track where the surgeon is looking and provides augmented reality cues to the camera operator explaining the camera desires of the surgeon. (2) Create a hardware / software environment for the tracking of a camera and an object, allowing for the display of registered pre-operative imaging that can be manipulated during the procedure. A set of augmented reality cues describing the translation, zoom, and roll of a laparoscopic camera were developed for Aim 1. An experiment was run to determine whether using augmented reality cues or verbal cues was faster and more efficient at acquiring targets on camera at a specific location, zoom level, and roll angle. The study found that in all instances, the augmented reality cues resulted in faster completion of the task with better economy of movement than with the verbal cues. A large number of environmentally registered augmented reality telestration and visualization features were added to a hardware / software platform for Aim 2. The implemented manipulation of pre-operative imaging and the ability to provide different types of registered annotation in the working environment has provided numerous examples of improved utility in telementoring systems. The results of this work provide potential improvements to the utilization of pre-operative imaging in the operating room, to the effectiveness of telementoring as a surgical teaching tool, and to the effective communication between the surgeon and the camera operator in laparoscopic surgery

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Telehealth in the developing world

Co-published with the Royal Society of Medicine Pres

Colorectal Cancer

The projections for future growth in the number of new patients with colorectal cancer in most parts of the world remain unfavorable. When we consider the substantial morbidity and mortality that accompanies the disease, the acute need for improvements and better solutions in patient care becomes evident. This volume, organized in five sections, represents a synopsis of the significant efforts from scientists, clinicians and investigators towards finding improvements in different patient care aspects including nutrition, diagnostic approaches, treatment strategies with the addition of some novel therapeutic approaches, and prevention. For scientists involved in investigations that explore fundamental cellular events in colorectal cancer, this volume provides a framework for translational integration of cell biological and clinical information. Clinicians as well as other healthcare professionals involved in patient management for colorectal cancer will find this volume useful

Yale Medicine : Alumni Bulletin of the School of Medicine, Fall 1994- Summer 1996

This volume contains Yale medicine: alumni bulletin of the School of Medicine, v.29 (Fall 1994) through v.30 (Summer 1996). Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965). Digitized with funding from the Arcadia fund, 2017.https://elischolar.library.yale.edu/yale_med_alumni_newsletters/1012/thumbnail.jp

Human-Centred Evaluation of Broadband Telehealth for Tertiary Outpatient Consultations: A Case Study Approach

Outpatient consultations form a large part of the healthcare of patients at tertiary hospitals, both as a precursor to in-patient treatment and for the management of on-going health conditions or long-term rehabilitation and monitoring after treatment. These outpatient consultations are generally conducted at the hospitals, most often located in large cities. Patients who live outside these cities face extensive travel to attend these consultations, placing a burden on themselves and on their families or carers. An ability of a tertiary hospital to deliver outpatient consultations in a telehealth mode to regional or remote locations closer to the patients’ homes would potentially relieve much of this burden of travel. ¶ ... ¶ In this thesis I use a case-study-based approach to evaluate the development and pilot trial of a broadband telehealth system in a tertiary paediatric context. I use the data from these case studies to explore the way that a human-centred approach can be used to evaluate outpatient telehealth trials at a tertiary level of healthcare. ..

Mobile depth sensing technology and algorithms with application to occupational therapy healthcare

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThe UK government is striving to shift its current healthcare delivery model from clini-cian–oriented services, to that of patient and self–care–oriented intervention strategies. It seeks to do so through Information Communication (ICT) and Computer Mediated Re-ality Technologies (CMRT) as a key strategy to overcome the ever–increasing scarcity of healthcare resources and costs. To this end, in the UK the use of paper–based information systems have exhibited their limitations in providing apposite care. At the national level, The Royal College of Occupational Therapists (RCOT) identify home visits and modifica-tions as key levers in a multifactorial health programme to evaluate interventions for older people with a history of falling or are identified as being prone to falling. Prescribing Assistive Equipment (AE) is one such mechanism that seeks to reduce the risk of falling whilst promoting the continued independence of physical dexterity and mobility in older adults at home. In the UK, the yearly cost of falls is estimated at £2.3 billion. Further evidence places a 30% to 60% abandonment rate on prescribed AE by and large due to a ‘poor fit’ and measurement inaccuracies. To remain aligned with the national strategy, and assist in the eradication of measurement inaccuracies, this thesis employs Mobile Depth Sensing and Motion Track-ing Devices (MDSMTDs) to assist OTs in in the process of digitally measuring the extrin-sic fall–risk factors for the provision of AE. The quintessential component in this assess-ment lies in the measurement of fittings and furniture items in the home. To digitise and aid in this process, the artefact presented in this thesis employs stereo computer–vision and camera calibration algorithms to extract edges in 3D space. It modifies the Sobel–Feldman convolution filter by reducing the magnitude response and employs the camera intrinsic parameters as a mechanism to calculate the distortion matrix for interpolation between the edges and the 3D point cloud. Further Augmented Reality User Experience (AR-UX) facets are provided to digitise current state of the art clinical guidance and over-lay its instructions onto the real world (i.e., 3D space). Empirical mixed methods assessment revealed that in terms of accuracy, the arte-fact exhibited enhanced performance gains over current paper–based guidance. In terms of accuracy consistency, the artefact can rectify measurement consistency inaccuracies, but there are still a wide range of factors that can influence the integrity of the point-cloud in respect of the device’s point-of-view, holding positions and measurement speed. To this end, OTs usability, and adoption preferences materialise in favour of the artefact. In conclusion, this thesis demonstrates that MDSMTDs are a promising alterna-tive to existing paper–based measurement practices as OTs appear to prefer the digital–based system and that they can take measurements more efficiently and accurately