Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Kontextsensitivität für den Operationssaal der Zukunft

The operating room of the future is a topic of high interest. In this thesis, which is among the first in the recently defined field of Surgical Data Science, three major topics for automated context awareness in the OR of the future will be examined: improved surgical workflow analysis, the newly developed event impact factors, and as application combining these and other concepts the unified surgical display.Der Operationssaal der Zukunft ist ein Forschungsfeld von großer Bedeutung. In dieser Dissertation, die eine der ersten im kürzlich definierten Bereich „Surgical Data Science“ ist, werden drei Themen für die automatisierte Kontextsensitivität im OP der Zukunft untersucht: verbesserte chirurgische Worflowanalyse, die neuentwickelten „Event Impact Factors“ und als Anwendungsfall, der diese Konzepte mit anderen kombiniert, das vereinheitlichte chirurgische Display

Workflow-based Context-aware Control of Surgical Robots

Surgical assistance system such as medical robots enhanced the capabilities of medical procedures in the last decades. This work presents a new perspective on the use of workflows with surgical robots in order to improve the technical capabilities and the ease of use of such systems. This is accomplished by a 3D perception system for the supervision of the surgical operating room and a workflow-based controller, that allows to monitor the surgical process using workflow-tracking techniques

Healthcare Robotics

Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key stakeholders, care settings, and tasks; reviewing recent advances in healthcare robotics; and outlining major challenges and opportunities to their adoption.Comment: 8 pages, Communications of the ACM, 201

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

Intraoperative process monitoring using generalized surgical process models

Der Chirurg in einem modernen Operationssaal kann auf die Funktionen einer Vielzahl technischer, seine Arbeit unterstützender, Geräte zugreifen. Diese Geräte und damit auch die Funktionen, die diese zur Verfügung stellen, sind nur unzureichend miteinander vernetzt. Die unzureichende Interoperabilität der Geräte bezieht sich dabei nicht nur auf den Austausch von Daten untereinander, sondern auch auf das Fehlen eines zentralen Wissens über den gesamten Ablauf des chirurgischen Prozesses. Es werden daher Systeme benötigt, die Prozessmodelle verarbeiten und damit globales Wissen über den Prozess zur Verfügung stellen können. Im Gegensatz zu den meisten Prozessen, die in der Wirtschaft durch Workflow Management-Systeme (WfMS) unterstützt werden, ist der chirurgische Prozess durch eine hohe Variabilität gekennzeichnet. Mittlerweile gibt es viele Ansätze feingranulare, hochformalisierte Modelle des chirurgischen Prozesses zu erstellen. In dieser Arbeit wird zum einen die Qualität eines, auf patienten individuellen Eingriffen basierenden, generalisierten Modells hinsichtlich der Abarbeitung durch ein WfMS untersucht, zum anderen werden die Voraussetzungen die, die vorgelagerten Systeme erfüllen müssen geprüft. Es wird eine Aussage zur Abbruchrate der Pfadverfolgung im generalisierten Modell gemacht, das durch eine unterschiedliche Anzahl von patientenindividuellen Modellen erstellt wurde. Zudem wird die Erfolgsrate zum Wiederfinden des Prozesspfades im Modell ermittelt. Ausserdem werden die Anzahl der benötigten Schritte zumWiederfinden des Prozesspfades im Modell betrachtet.:List of Figures iv List of Tables vi 1 Introduction 1 1.1 Motivation 1 1.2 Problems and objectives 3 2 State of research 6 2.1 Definitions of terms 6 2.1.1 Surgical process 6 2.1.2 Surgical Process Model 7 2.1.3 gSPM and surgical workflow 7 2.1.4 Surgical workflow management system 8 2.1.5 Summary 9 2.2 Workflow Management Systems 10 2.2.1 Agfa HealthCare - ORBIS 10 2.2.2 Siemens Clinical Solutions - Soarian 10 2.2.3 Karl Storz - ORchestrion 10 2.2.4 YAWL BPM 11 2.3 Sensor systems 12 2.3.1 Sensors according to DIN1319 13 2.3.2 Video-based sensor technology 14 2.3.3 Human-based sensor technology 15 2.3.4 Summary 15 2.4 Process model 15 2.4.1 Top-Down 15 2.4.2 Bottom-Up 17 2.4.3 Summary 18 2.5 Methods for creating the ICCAS process model 18 2.5.1 Recording of the iSPMs 18 2.5.2 Creation of the gSPMs 20 2.6 Summary 21 3 Model-based design of workflow schemas 23 3.1 Abstract 24 3.2 Introduction 25 3.3 Model driven design of surgical workflow schemata 27 3.3.1 Recording of patient individual surgical process models 27 3.3.2 Generating generalized SPM from iSPMs 27 3.3.3 Transforming gSPM into workflow schemata 28 3.4 Summary and Outlook 30 4 Model-based validation of workflow schemas 31 4.1 Abstract 32 4.2 Introduction 33 4.3 Methods 36 4.3.1 Surgical Process Modeling 36 4.3.2 Workflow Schema Generation 38 4.3.3 The SurgicalWorkflow Management and Simulation System 40 4.3.4 System Validation Study Design 42 4.4 Results 44 4.5 Discussion 47 4.6 Conclusion 50 4.7 Acknowledgments 51 5 Influence of missing sensor information 52 5.1 Abstract 53 5.2 Introduction 54 5.3 Methodology 57 5.3.1 Surgical process modeling 57 5.3.2 Test system 59 5.3.3 System evaluation study design 61 5.4 Results 63 5.5 Discussion 66 5.6 Conclusion 68 5.7 Acknowledgments 68 5.8 Conflict of interest 68 6 Summary and outlook 69 6.1 Summary 69 6.2 Outlook 70 Bibliography 7

Utilizing artificial intelligence in perioperative patient flow:systematic literature review

Abstract. The purpose of this thesis was to map the existing landscape of artificial intelligence (AI) applications used in secondary healthcare, with a focus on perioperative care. The goal was to find out what systems have been developed, and how capable they are at controlling perioperative patient flow. The review was guided by the following research question: How is AI currently utilized in patient flow management in the context of perioperative care? This systematic literature review examined the current evidence regarding the use of AI in perioperative patient flow. A comprehensive search was conducted in four databases, resulting in 33 articles meeting the inclusion criteria. Findings demonstrated that AI technologies, such as machine learning (ML) algorithms and predictive analytics tools, have shown somewhat promising outcomes in optimizing perioperative patient flow. Specifically, AI systems have proven effective in predicting surgical case durations, assessing risks, planning treatments, supporting diagnosis, improving bed utilization, reducing cancellations and delays, and enhancing communication and collaboration among healthcare providers. However, several challenges were identified, including the need for accurate and reliable data sources, ethical considerations, and the potential for biased algorithms. Further research is needed to validate and optimize the application of AI in perioperative patient flow. The contribution of this thesis is summarizing the current state of the characteristics of AI application in perioperative patient flow. This systematic literature review provides information about the features of perioperative patient flow and the clinical tasks of AI applications previously identified

Inductive learning of the surgical workflow model through video annotations

partially_open5siSurgical workflow modeling is becoming increasingly useful to train surgical residents for complex surgical procedures. Rule-based surgical workflows have shown to be useful to create context-aware systems. However, manually constructing production rules is a time-intensive and laborious task. With the expansion of new technologies, large video archive can be created and annotated exploiting and storing the expert’s knowledge. This paper presents a prototypical study of automatic generation of production rules, in the Horn-clause, using the First Order Inductive Learner (FOIL) algorithm applied to annotated surgical videos of Thoracentesis procedure and of its feasibility to use in context-aware system framework. The algorithm was able to learn 18 rules for surgical workflow model with 0.88 precision, and 0.94 F1 score on the standard video annotation data, representing entities of the surgical workflow, which was used to retrieve contextual information on Thoracentesis workflow for its application to surgical training.openNakawala, HIRENKUMAR CHANDRAKANT; DE MOMI, Elena; Pescatori, Erica Laura; Morelli, Anna; Ferrigno, GiancarloNakawala, HIRENKUMAR CHANDRAKANT; DE MOMI, Elena; Pescatori, Erica Laura; Morelli, Anna; Ferrigno, Giancarl