6,908 research outputs found
Recent trends, technical concepts and components of computer-assisted orthopedic surgery systems: A comprehensive review
Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.Web of Science1923art. no. 519
Robot Autonomy for Surgery
Autonomous surgery involves having surgical tasks performed by a robot
operating under its own will, with partial or no human involvement. There are
several important advantages of automation in surgery, which include increasing
precision of care due to sub-millimeter robot control, real-time utilization of
biosignals for interventional care, improvements to surgical efficiency and
execution, and computer-aided guidance under various medical imaging and
sensing modalities. While these methods may displace some tasks of surgical
teams and individual surgeons, they also present new capabilities in
interventions that are too difficult or go beyond the skills of a human. In
this chapter, we provide an overview of robot autonomy in commercial use and in
research, and present some of the challenges faced in developing autonomous
surgical robots
A new mini-navigation tool allows accurate component placement during anterior total hip arthroplasty.
Introduction: Computer-assisted navigation systems have been explored in total hip arthroplasty (THA) to improve component positioning. While these systems traditionally rely on anterior pelvic plane registration, variances in soft tissue thickness overlying anatomical landmarks can lead to registration error, and the supine coronal plane has instead been proposed. The purpose of this study was to evaluate the accuracy of a novel navigation tool, using registration of the anterior pelvic plane or supine coronal plane during simulated anterior THA.
Methods: Measurements regarding the acetabular component position, and changes in leg length and offset were recorded. Benchtop phantoms and target measurement values commonly seen in surgery were used for analysis. Measurements for anteversion and inclination, and changes in leg length and offset were recorded by the navigation tool and compared with the known target value of the simulation. Pearson\u27s
Results: The device accurately measured cup position and leg length measurements to within 1° and 1 mm of the known target values, respectively. Across all simulations, there was a strong, positive relationship between values obtained by the device and the known target values (
Conclusion: The preliminary findings of this study suggest that the novel navigation tool tested is a potentially viable tool to improve the accuracy of component placement during THA using the anterior approach
A surgical system for automatic registration, stiffness mapping and dynamic image overlay
In this paper we develop a surgical system using the da Vinci research kit
(dVRK) that is capable of autonomously searching for tumors and dynamically
displaying the tumor location using augmented reality. Such a system has the
potential to quickly reveal the location and shape of tumors and visually
overlay that information to reduce the cognitive overload of the surgeon. We
believe that our approach is one of the first to incorporate state-of-the-art
methods in registration, force sensing and tumor localization into a unified
surgical system. First, the preoperative model is registered to the
intra-operative scene using a Bingham distribution-based filtering approach. An
active level set estimation is then used to find the location and the shape of
the tumors. We use a recently developed miniature force sensor to perform the
palpation. The estimated stiffness map is then dynamically overlaid onto the
registered preoperative model of the organ. We demonstrate the efficacy of our
system by performing experiments on phantom prostate models with embedded stiff
inclusions.Comment: International Symposium on Medical Robotics (ISMR 2018
A fast and robust patient specific Finite Element mesh registration technique: application to 60 clinical cases
Finite Element mesh generation remains an important issue for patient
specific biomechanical modeling. While some techniques make automatic mesh
generation possible, in most cases, manual mesh generation is preferred for
better control over the sub-domain representation, element type, layout and
refinement that it provides. Yet, this option is time consuming and not suited
for intraoperative situations where model generation and computation time is
critical. To overcome this problem we propose a fast and automatic mesh
generation technique based on the elastic registration of a generic mesh to the
specific target organ in conjunction with element regularity and quality
correction. This Mesh-Match-and-Repair (MMRep) approach combines control over
the mesh structure along with fast and robust meshing capabilities, even in
situations where only partial organ geometry is available. The technique was
successfully tested on a database of 5 pre-operatively acquired complete femora
CT scans, 5 femoral heads partially digitized at intraoperative stage, and 50
CT volumes of patients' heads. The MMRep algorithm succeeded in all 60 cases,
yielding for each patient a hex-dominant, Atlas based, Finite Element mesh with
submillimetric surface representation accuracy, directly exploitable within a
commercial FE software
Augmented Reality-based Feedback for Technician-in-the-loop C-arm Repositioning
Interventional C-arm imaging is crucial to percutaneous orthopedic procedures
as it enables the surgeon to monitor the progress of surgery on the anatomy
level. Minimally invasive interventions require repeated acquisition of X-ray
images from different anatomical views to verify tool placement. Achieving and
reproducing these views often comes at the cost of increased surgical time and
radiation dose to both patient and staff. This work proposes a marker-free
"technician-in-the-loop" Augmented Reality (AR) solution for C-arm
repositioning. The X-ray technician operating the C-arm interventionally is
equipped with a head-mounted display capable of recording desired C-arm poses
in 3D via an integrated infrared sensor. For C-arm repositioning to a
particular target view, the recorded C-arm pose is restored as a virtual object
and visualized in an AR environment, serving as a perceptual reference for the
technician. We conduct experiments in a setting simulating orthopedic trauma
surgery. Our proof-of-principle findings indicate that the proposed system can
decrease the 2.76 X-ray images required per desired view down to zero,
suggesting substantial reductions of radiation dose during C-arm repositioning.
The proposed AR solution is a first step towards facilitating communication
between the surgeon and the surgical staff, improving the quality of surgical
image acquisition, and enabling context-aware guidance for surgery rooms of the
future. The concept of technician-in-the-loop design will become relevant to
various interventions considering the expected advancements of sensing and
wearable computing in the near future
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
Towards multiple 3D bone surface identification and reconstruction using few 2D X-ray images for intraoperative applications
This article discusses a possible method to use a small number, e.g. 5, of conventional 2D X-ray images to reconstruct multiple 3D bone surfaces intraoperatively. Each bone’s edge contours in X-ray images are automatically identified. Sparse 3D landmark points of each bone are automatically reconstructed by pairing the 2D X-ray images. The reconstructed landmark point distribution on a surface is approximately optimal covering main characteristics of the surface. A statistical shape model, dense point distribution model (DPDM), is then used to fit the reconstructed optimal landmarks vertices to reconstruct a full surface of each bone separately. The reconstructed surfaces can then be visualised and manipulated by surgeons or used by surgical robotic systems
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