17,834 research outputs found
NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator
Purpose: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is a novel technique in minimally invasive surgery whereby a flexible endoscope is inserted via a natural orifice to gain access to the abdominal cavity, leaving no external scars. This innovative use of flexible endoscopy creates many new challenges and is associated with a steep learning curve for clinicians. Methods: We developed NOViSE - the first force-feedback enabled virtual reality simulator for NOTES training supporting a flexible endoscope. The haptic device is custom built and the behaviour of the virtual flexible endoscope is based on an established theoretical framework – the Cosserat Theory of Elastic Rods. Results: We present the application of NOViSE to the simulation of a hybrid trans-gastric cholecystectomy procedure. Preliminary results of face, content and construct validation have previously shown that NOViSE delivers the required level of realism for training of endoscopic manipulation skills specific to NOTES Conclusions: VR simulation of NOTES procedures can contribute to surgical training and improve the educational experience without putting patients at risk, raising ethical issues or requiring expensive animal or cadaver facilities. In the context of an experimental technique, NOViSE could potentially facilitate NOTES development and contribute to its wider use by keeping practitioners up to date with this novel surgical technique. NOViSE is a first prototype and the initial results indicate that it provides promising foundations for further development
Focal Spot, Fall/Winter 1996
https://digitalcommons.wustl.edu/focal_spot_archives/1071/thumbnail.jp
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
Autonomous Tissue Scanning under Free-Form Motion for Intraoperative Tissue Characterisation
In Minimally Invasive Surgery (MIS), tissue scanning with imaging probes is
required for subsurface visualisation to characterise the state of the tissue.
However, scanning of large tissue surfaces in the presence of deformation is a
challenging task for the surgeon. Recently, robot-assisted local tissue
scanning has been investigated for motion stabilisation of imaging probes to
facilitate the capturing of good quality images and reduce the surgeon's
cognitive load. Nonetheless, these approaches require the tissue surface to be
static or deform with periodic motion. To eliminate these assumptions, we
propose a visual servoing framework for autonomous tissue scanning, able to
deal with free-form tissue deformation. The 3D structure of the surgical scene
is recovered and a feature-based method is proposed to estimate the motion of
the tissue in real-time. A desired scanning trajectory is manually defined on a
reference frame and continuously updated using projective geometry to follow
the tissue motion and control the movement of the robotic arm. The advantage of
the proposed method is that it does not require the learning of the tissue
motion prior to scanning and can deal with free-form deformation. We deployed
this framework on the da Vinci surgical robot using the da Vinci Research Kit
(dVRK) for Ultrasound tissue scanning. Since the framework does not rely on
information from the Ultrasound data, it can be easily extended to other
probe-based imaging modalities.Comment: 7 pages, 5 figures, ICRA 202
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
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
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