4,995 research outputs found
Computer-assisted access to the kidney
OBJECTIVES: The aim of this paper is to introduce the principles of
computer-assisted access to the kidney. The system provides the surgeon with a
pre-operative 3D planning on computed tomography (CT) images. After a rigid
registration with space-localized ultrasound (US) data, preoperative planning
can be transferred to the intra-operative conditions and an intuitive
man-machine interface allows the user to perform a puncture. MATERIAL AND
METHODS: Both CT and US images of informed normal volunteer were obtained to
perform calculation on the accuracy of registration and punctures were carried
out on a kidney phantom to measure the precision of the whole of the system.
RESULTS: We carried out millimetric registrations on real data and guidance
experiments on a kidney phantom showed encouraging results of 4.7 mm between
planned and reached targets. We noticed that the most significant error was
related to the needle deflection during the puncture. CONCLUSION: Preliminary
results are encouraging. Further work will be undertaken to improve efficiency
and accuracy, and to take breathing into account
Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology
Until recently, Computer-Aided Medical Interventions (CAMI) and Medical
Robotics have focused on rigid and non deformable anatomical structures.
Nowadays, special attention is paid to soft tissues, raising complex issues due
to their mobility and deformation. Mini-invasive digestive surgery was probably
one of the first fields where soft tissues were handled through the development
of simulators, tracking of anatomical structures and specific assistance
robots. However, other clinical domains, for instance urology, are concerned.
Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU,
radiofrequency, or cryoablation), increasingly early detection of cancer, and
use of interventional and diagnostic imaging modalities, recently opened new
challenges to the urologist and scientists involved in CAMI. This resulted in
the last five years in a very significant increase of research and developments
of computer-aided urology systems. In this paper, we propose a description of
the main problems related to computer-aided diagnostic and therapy of soft
tissues and give a survey of the different types of assistance offered to the
urologist: robotization, image fusion, surgical navigation. Both research
projects and operational industrial systems are discussed
Computer- and robot-assisted Medical Intervention
Medical robotics includes assistive devices used by the physician in order to
make his/her diagnostic or therapeutic practices easier and more efficient.
This chapter focuses on such systems. It introduces the general field of
Computer-Assisted Medical Interventions, its aims, its different components and
describes the place of robots in that context. The evolutions in terms of
general design and control paradigms in the development of medical robots are
presented and issues specific to that application domain are discussed. A view
of existing systems, on-going developments and future trends is given. A
case-study is detailed. Other types of robotic help in the medical environment
(such as for assisting a handicapped person, for rehabilitation of a patient or
for replacement of some damaged/suppressed limbs or organs) are out of the
scope of this chapter.Comment: Handbook of Automation, Shimon Nof (Ed.) (2009) 000-00
Registration of ultrasound and computed tomography for guidance of laparoscopic liver surgery
Laparoscopic Ultrasound (LUS) imaging is a standard tool used for image-guidance during laparoscopic liver resection, as it provides real-time information on the internal structure of the liver. However, LUS probes are di cult to handle and their resulting images hard to interpret. Additionally, some anatomical targets such as tumours are not always visible, making the LUS guidance less e ective. To solve this problem, registration between the LUS images and a pre-operative Computed Tomography (CT) scan using information from blood vessels has been previously proposed. By merging these two modalities, the relative position between the LUS images and the anatomy of CT is obtained and both can be used to guide the surgeon. The problem of LUS to CT registration is specially challenging, as besides being a multi-modal registration, the eld of view of LUS is signi cantly smaller than that of CT. Therefore, this problem becomes poorly constrained and typically an accurate initialisation is needed. Also, the liver is highly deformed during laparoscopy, complicating the problem further. So far, the methods presented in the literature are not clinically feasible as they depend on manually set correspondences between both images. In this thesis, a solution for this registration problem that may be more transferable to the clinic is proposed. Firstly, traditional registration approaches comprised of manual initialisation and optimisation of a cost function are studied. Secondly, it is demonstrated that a globally optimal registration without a manual initialisation is possible. Finally, a new globally optimal solution that does not require commonly used tracking technologies is proposed and validated. The resulting approach provides clinical value as it does not require manual interaction in the operating room or tracking devices. Furthermore, the proposed method could potentially be applied to other image-guidance problems that require registration between ultrasound and a pre-operative scan
In vivo measurement of human brain elasticity using a light aspiration device
The brain deformation that occurs during neurosurgery is a serious issue
impacting the patient "safety" as well as the invasiveness of the brain
surgery. Model-driven compensation is a realistic and efficient solution to
solve this problem. However, a vital issue is the lack of reliable and easily
obtainable patient-specific mechanical characteristics of the brain which,
according to clinicians' experience, can vary considerably. We designed an
aspiration device that is able to meet the very rigorous sterilization and
handling process imposed during surgery, and especially neurosurgery. The
device, which has no electronic component, is simple, light and can be
considered as an ancillary instrument. The deformation of the aspirated tissue
is imaged via a mirror using an external camera. This paper describes the
experimental setup as well as its use during a specific neurosurgery. The
experimental data was used to calibrate a continuous model. We show that we
were able to extract an in vivo constitutive law of the brain elasticity: thus
for the first time, measurements are carried out per-operatively on the
patient, just before the resection of the brain parenchyma. This paper
discloses the results of a difficult experiment and provide for the first time
in-vivo data on human brain elasticity. The results point out the softness as
well as the highly non-linear behavior of the brain tissue.Comment: Medical Image Analysis (2009) accept\'
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
Registration of Untracked 2D Laparoscopic Ultrasound Liver Images to CT Using Content-Based Retrieval and Kinematic Priors
Laparoscopic Ultrasound (LUS) can enhance the safety of laparoscopic liver resection by providing information on the location of major blood vessels and tumours. Since many tumours are not visible in ultrasound, registration to a pre-operative CT has been proposed as a guidance method. In addition to being multi-modal, this registration problem is greatly affected by the differences in field of view between CT and LUS, and thus requires an accurate initialisation. We propose a novel method of registering smaller field of view slices to a larger volume globally using a Content-based retrieval framework. This problem is under-constrained for a single slice registration, resulting in non-unique solutions. Therefore, we introduce kinematic priors in a Bayesian framework in order to jointly register groups of ultrasound images. Our method then produces an estimate of the most likely sequence of CT images to represent the ultrasound acquisition and does not require tracking information nor an accurate initialisation. We demonstrate the feasibility of this approach in multiple LUS acquisitions taken from three sets of clinical data
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