Developing a virtual reality environment for petrous bone surgery: a state-of-the-art review

The increasing power of computers has led to the development of sophisticated systems that aim to immerse the user in a virtual environment. The benefits of this type of approach to the training of physicians and surgeons are immediately apparent. Unfortunately the implementation of “virtual reality” (VR) surgical simulators has been restricted by both cost and technical limitations. The few successful systems use standardized scenarios, often derived from typical clinical data, to allow the rehearsal of procedures. In reality we would choose a system that allows us not only to practice typical cases but also to enter our own patient data and use it to define the virtual environment. In effect we want to re-write the scenario every time we use the environment and to ensure that its behavior exactly duplicates the behavior of the real tissue. If this can be achieved then VR systems can be used not only to train surgeons but also to rehearse individual procedures where variations in anatomy or pathology present specific surgical problems. The European Union has recently funded a multinational 3-year project (IERAPSI, Integrated Environment for Rehearsal and Planning of Surgical Interventions) to produce a virtual reality system for surgical training and for rehearsing individual procedures. Building the IERAPSI system will bring together a wide range of experts and combine the latest technologies to produce a true, patient specific virtual reality surgical simulator for petrous/temporal bone procedures. This article presents a review of the “state of the art” technologies currently available to construct a system of this type and an overview of the functionality and specifications such a system requires

The Challenge of Augmented Reality in Surgery

Imaging has revolutionized surgery over the last 50 years. Diagnostic imaging is a key tool for deciding to perform surgery during disease management; intraoperative imaging is one of the primary drivers for minimally invasive surgery (MIS), and postoperative imaging enables effective follow-up and patient monitoring. However, notably, there is still relatively little interchange of information or imaging modality fusion between these different clinical pathway stages. This book chapter provides a critique of existing augmented reality (AR) methods or application studies described in the literature using relevant examples. The aim is not to provide a comprehensive review, but rather to give an indication of the clinical areas in which AR has been proposed, to begin to explain the lack of clinical systems and to provide some clear guidelines to those intending pursue research in this area

Recent Advancements in Augmented Reality for Robotic Applications: A Survey

Robots are expanding from industrial applications to daily life, in areas such as medical robotics, rehabilitative robotics, social robotics, and mobile/aerial robotics systems. In recent years, augmented reality (AR) has been integrated into many robotic applications, including medical, industrial, human–robot interactions, and collaboration scenarios. In this work, AR for both medical and industrial robot applications is reviewed and summarized. For medical robot applications, we investigated the integration of AR in (1) preoperative and surgical task planning; (2) image-guided robotic surgery; (3) surgical training and simulation; and (4) telesurgery. AR for industrial scenarios is reviewed in (1) human–robot interactions and collaborations; (2) path planning and task allocation; (3) training and simulation; and (4) teleoperation control/assistance. In addition, the limitations and challenges are discussed. Overall, this article serves as a valuable resource for working in the field of AR and robotic research, offering insights into the recent state of the art and prospects for improvement

A Review of Indocyanine Green Fluorescent Imaging in Surgery

The purpose of this paper is to give an overview of the recent surgical intraoperational applications of indocyanine green fluorescence imaging methods, the basics of the technology, and instrumentation used. Well over 200 papers describing this technique in clinical setting are reviewed. In addition to the surgical applications, other recent medical applications of ICG are briefly examined

Optimised Calibration, Registration and Tracking for Image Enhanced Surgical Navigation in ENT Operations

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Optimised calibration, registration and tracking for image enhanced surgical navigation in ENT operations

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Characterising pattern asymmetry in pigmented skin lesions

Abstract. In clinical diagnosis of pigmented skin lesions asymmetric pigmentation is often indicative of melanoma. This paper describes a method and measures for characterizing lesion symmetry. The estimate of mirror symmetry is computed first for a number of axes at different degrees of rotation with respect to the lesion centre. The statistics of these estimates are the used to assess the overall symmetry. The method is applied to three different lesion representations showing the overall pigmentation, the pigmentation pattern, and the pattern of dermal melanin. The best measure is a 100% sensitive and 96% specific indicator of melanoma on a test set of 33 lesions, with a separate training set consisting of 66 lesions

Development and evaluation of a novel method for in-situ medical image display

Three-dimensional (3D) medical imaging, including computed tomography (CT) and magnetic resonance (MR), and other modalities, has become a standard of care for diagnosis of disease and guidance of interventional procedures. As the technology to acquire larger, more magnificent, and more informative medical images advances, so too must the technology to display, interact with, and interpret these data.This dissertation concerns the development and evaluation of a novel method for interaction with 3D medical images called "grab-a-slice," which is a movable, tracked stereo display. It is the latest in a series of displays developed in our laboratory that we describe as in-situ, meaning that the displayed image is embedded in a physical 3D coordinate system. As the display is moved through space, a continuously updated tomographic slice of a 3D medical image is shown on the screen, corresponding to the position and orientation of the display. The act of manipulating the display through a "virtual patient" preserves the perception of 3D anatomic relationships in a way that is not possible with conventional, fixed displays. The further addition of stereo display capabilities permits augmentation of the tomographic image data with out-of-plane structures using 3D graphical methods.In this dissertation we describe the research and clinical motivations for such a device. We describe the technical development of grab-a-slice as well as psychophysical experiments to evaluate the hypothesized perceptual and cognitive benefits. We speculate on the advantages and limitations of the grab-a-slice display and propose future directions for its use in psychophysical research, clinical settings, and image analysis

Direct Manipulation Of Virtual Objects

Interacting with a Virtual Environment (VE) generally requires the user to correctly perceive the relative position and orientation of virtual objects. For applications requiring interaction in personal space, the user may also need to accurately judge the position of the virtual object relative to that of a real object, for example, a virtual button and the user\u27s real hand. This is difficult since VEs generally only provide a subset of the cues experienced in the real world. Complicating matters further, VEs presented by currently available visual displays may be inaccurate or distorted due to technological limitations. Fundamental physiological and psychological aspects of vision as they pertain to the task of object manipulation were thoroughly reviewed. Other sensory modalities--proprioception, haptics, and audition--and their cross-interactions with each other and with vision are briefly discussed. Visual display technologies, the primary component of any VE, were canvassed and compared. Current applications and research were gathered and categorized by different VE types and object interaction techniques. While object interaction research abounds in the literature, pockets of research gaps remain. Direct, dexterous, manual interaction with virtual objects in Mixed Reality (MR), where the real, seen hand accurately and effectively interacts with virtual objects, has not yet been fully quantified. An experimental test bed was designed to provide the highest accuracy attainable for salient visual cues in personal space. Optical alignment and user calibration were carefully performed. The test bed accommodated the full continuum of VE types and sensory modalities for comprehensive comparison studies. Experimental designs included two sets, each measuring depth perception and object interaction. The first set addressed the extreme end points of the Reality-Virtuality (R-V) continuum--Immersive Virtual Environment (IVE) and Reality Environment (RE). This validated, linked, and extended several previous research findings, using one common test bed and participant pool. The results provided a proven method and solid reference points for further research. The second set of experiments leveraged the first to explore the full R-V spectrum and included additional, relevant sensory modalities. It consisted of two full-factorial experiments providing for rich data and key insights into the effect of each type of environment and each modality on accuracy and timeliness of virtual object interaction. The empirical results clearly showed that mean depth perception error in personal space was less than four millimeters whether the stimuli presented were real, virtual, or mixed. Likewise, mean error for the simple task of pushing a button was less than four millimeters whether the button was real or virtual. Mean task completion time was less than one second. Key to the high accuracy and quick task performance time observed was the correct presentation of the visual cues, including occlusion, stereoscopy, accommodation, and convergence. With performance results already near optimal level with accurate visual cues presented, adding proprioception, audio, and haptic cues did not significantly improve performance. Recommendations for future research include enhancement of the visual display and further experiments with more complex tasks and additional control variables