Using Fluorescence – Polarization Endoscopy in Detection of Precancerous and Cancerous Lesions in Colon and Pancreatic Cancer

Colitis-associated cancer (CAC) arises from premalignant flat lesions of the colon, which are difficult to detect with current endoscopic screening approaches. We have developed a complementary fluorescence and polarization reporting strategy that combines the unique biochemical and physical properties of dysplasia and cancer for real time detection of these lesions. Utilizing a new thermoresponsive sol-gel formulation with targeted molecular probe allowed topical application and detection of precancerous and cancerous lesions during endoscopy. Incorporation of nanowire-filtered polarization imaging into NIR fluorescence endoscopy served as a validation strategy prior to obtaining biopsies. In order to reduce repeat surgeries arising from incomplete tumor resection, we demonstrated the efficacy of the targeted molecular probe towards margins of sporadic colorectal cancer (SCC). Fluorescence-polarization microscopy using circular polarized (CP) light served as a rapid, supplementary tool for assessment and validation of excised tissue to ensure complete tumor resection for examining tumor margins prior to H&E-based pathological diagnosis. We extended our platform towards non-invasive directed detection of pancreatic cancer utilizing fluorescence molecular tomography (FMT) and NIR laparoscopy using identified targeted molecular probe. We were able to non-invasively distinguished between pancreatitis and pancreatic cancer and guide pancreatic tumor resection using NIR laparoscopy

Uporaba piezoelektričnog svojstva u poboljšanju kvalitete instrumenata i sigurnosti bolesnika u laparoskopskoj kirurgiji

The piezoelectric properties of some natural crystals and polymers can also be used in surgery. For this purpose, a prototype of an endoscopic instrument was constructed with piezoelectric material attached to its working end with the aim of recognizing pulsating blood vessels during laparoscopic surgery. To test the properties of the new instrument in laboratory conditions, simulated blood circulation was used with the possibility of changing pressure and frequency. The instrument was tested in the pressure range of 40-180 mm Hg at constant frequency of 72/min and frequency range of 36-130 beats per minute at constant pressure of 120 mm Hg. Test results showed that the instrument with certainty recognized a pulsating “blood vessel” in the expected pressure ranges and at different blood pump frequencies. Given the piezoelectric material’s very small dimensions and flexible form, it can be installed at the working end of most standard laparoscopic instruments and thus significantly increase certainty in the recognition of arteries during surgery, which would reduce the possibility of their injury or accidental ligation.Piezoelektrična svojstva nekih prirodnih kristala i nekih polimera moguće je koristiti i u kirurgiji. U tu svrhu konstruiran je prototip endoskopskog instrumenta na čijem je radnom dijelu ugrađen piezoelektrični materijal s ciljem prepoznavanja pulzirajućih krvnih žila tijekom laparoskopskih operacija. Za ispitivanje svojstava novoga instrumenta u laboratorijskim uvjetima korišten je simulirani krvotok s mogućnošću mijenjanja tlaka i frekvencije. Rad instrumenta je ispitivan u rasponu tlakova 40-180 mm Hg uz konstantnu frekvenciju 72/min, te u rasponu frekvencija 36-130 otkucaja u minuti uz konstantan tlak 120 mm Hg. Rezultati ispitivanja pokazuju da instrument sa sigurnošću prepoznaje pulzirajuću „krvnu žilu“ u očekivanom rasponu tlakova i pri različitim frekvencijama rada krvne pumpe. S obzirom na to da se radi o vrlo malim dimenzijama i prilagodljivim oblicima piezoelektričkog materijala, moguće ga je postaviti na radni dio većine standardnih laparoskopskih instrumenata i time značajno povećati sigurnost prepoznavanja arterija tijekom operacijskog zahvata, što bi smanjilo mogućnost njihove ozljede ili slučajnog podvezivanja

Towards an Accurate Tracking of Liver Tumors for Augmented Reality in Robotic Assisted Surgery

International audienceThis article introduces a method for tracking the internal structures of the liver during robot-assisted procedures. Vascular network, tumors and cut planes, computed from pre-operative data, can be overlaid onto the laparoscopic view for image-guidance, even in the case of large motion or deformation of the organ. Compared to current methods, our method is able to precisely propagate surface motion to the internal structures. This is made possible by relying on a fast yet accurate biomechanical model of the liver combined with a robust visual tracking approach designed to properly constrain the model. Augmentation results are demonstrated on in-vivo sequences of a human liver during robotic surgery, while quantitative validation is performed on an ex-vivo porcine liver experimentation. Validation results show that our approach gives an accurate surface registration with an error of less than 6mm on the position of the tumor

Réalité augmentée pour la chirurgie minimalement invasive du foie utilisant un modèle biomécanique guidé par l'image

National audienceCet article présente une méthode de réalité augmentée pour la chirurgie minimalement invasive du foie. Le réseau vasculaire et les tumeurs internes reconstruites à partir des données pré-opératoires (IRM ou CT) peuvent ainsi être visualisées dans l'image laparoscopique afin de guider les gestes du chirurgien pendant l'opération. Cette méthode est capable de propager les déformations 3D de la surface du foie à ses structures internes grâce à un modèle biomécanique sous-jacent qui prend en compte l'anisotropie et l'hétérogénéité du tissu hépatique. Des résultats sont montrés sur une vidéo in-vivo d'un foie humain acquise pendant une opération et sur un foie en silicone

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

UWB Path Loss Models for Ingestible Devices

[EN] Currently, some medical devices such as the Wireless Capsule Endoscopy (WCE) are used for data transmission from inside to outside the body. Nevertheless, for certain applications such as WCE, the data rates offered by current medical frequency bands can result insufficient. Ultra Wideband (UWB) frequency band has become an interesting solution for this. However, to date, there is not a formal channel path loss model for the UWB frequency band in the gastrointestinal (GI) scenario due to the huge differences between the proposed studies. There are three main methodologies to characterize the propagation channel, software simulations and experimental measurements either in phantom or in in vivo animals. Previous works do not compare all the methodologies or present some disagreements with the literature. In this paper, a dedicated study of the path loss using the three methodologies aforementioned (simulations, phantoms and in vivo measurements) and a comparison with previous researches in the literature is performed. Moreover, numerical values for a path loss model which agrees with the three methodologies and the literature are proposed. This paper aims at being the starting point for a formal path loss model in the UWB frequency band for WBANs in the GI scenarioThis work was supported in part by the European Union's H2020-MSCA-ITN Program for the "Wireless In-body Environment Communication" Project under Grant 675353, in part by the Programa de Ayudas de Investigacion y Desarrollo (PAID-01-16) from Universitat Politecnica de Valencia, and in part by the Ministerio de Economia y Competitividad, Spain under Grant TEC2014-60258-C2-1-R through the European FEDER Funds.Pérez-Simbor, S.; Andreu-Estellés, C.; Garcia-Pardo, C.; Frasson, M.; Cardona Marcet, N. (2019). UWB Path Loss Models for Ingestible Devices. IEEE Transactions on Antennas and Propagation. 67(8):5025-5034. https://doi.org/10.1109/TAP.2019.2891717S5025503467

Schistosomiasis at the crossroad to elimination: review of eclipsed research with emphasis on the post-transmission agenda

While chronic schistosomiasis is pathologically well defined, the acute form of the disease is less well understood. It is generally agreed that early lesions, such as lung nodules and bladder polyps, are reversible, which impedes identification of the time elapsed since exposure. The intermediate stage between the acute and the chronic forms of schistosomiasis requires further investigation, as does the clinical stage due to lesions remaining after treatment. With current schistosomiasis control efforts gradually progressing to elimination, there is a need to focus on post-transmission schistosomiasis, which not only refers to remaining lesions from previous infections, but also accounts for the potential presence of surviving worms after treatment. This issue is particularly salient for migrants from endemic to non-endemic countries and should be kept in mind for returning expatriates from schistosomiasis-endemic countries. Negative stool examination or urine filtration are generally taken as indicative of cure since rectoscopy for Schistosoma mansoni infection, or cystoscopy for S. haematobium infection, are rarely performed. However, pathology of affected organs may persist indefinitely, while potentially remaining live worms could produce additional pathology. Hence, post-transmission schistosomiasis can prevail for years after elimination of the disease, and thus, warrant further attention

Magnetically Activated Stereoscopic Vision System for Laparoendoscopic Single-Site Surgery

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