Realistic and interactive high-resolution 4D environments for real-time surgeon and patient interaction

Copyright © 2016 John Wiley & Sons, Ltd. Background: Remote consultations that are realistic enough to be useful medically offer considerable clinical, logistical and cost benefits. Despite advances in virtual reality and vision hardware and software, these benefits are currently often unrealised. Method: The proposed approach combines high spatial and temporal resolution 3D and 2D machine vision with virtual reality techniques, in order to develop new environments and instruments that will enable realistic remote consultations and the generation of new types of useful clinical data. Results: New types of clinical data have been generated for skin analysis and respiration measurement; and the combination of 3D with 2D data was found to offer potential for the generation of realistic virtual consultations. Conclusion: An innovative combination of high resolution machine vision data and virtual reality online methods, promises to provide advanced functionality and significant medical benefits, particularly in regions where populations are dispersed or access to clinicians is limited. Copyright © 2016 John Wiley & Sons, Ltd

Virtual Reality applied to biomedical engineering

Actualment, la realitat virtual esta sent tendència i s'està expandint a l'àmbit mèdic, fent possible l'aparició de nombroses aplicacions dissenyades per entrenar metges i tractar pacients de forma més eficient, així com optimitzar els processos de planificació quirúrgica. La necessitat mèdica i objectiu d'aquest projecte és fer òptim el procés de planificació quirúrgica per a cardiopaties congènites, que compren la reconstrucció en 3D del cor del pacient i la seva integració en una aplicació de realitat virtual. Seguint aquesta línia s’ha combinat un procés de modelat 3D d’imatges de cors obtinguts gracies al Hospital Sant Joan de Déu i el disseny de l’aplicació mitjançant el software Unity 3D gracies a l’empresa VISYON. S'han aconseguit millores en quant al software emprat per a la segmentació i reconstrucció, i s’han assolit funcionalitats bàsiques a l’aplicació com importar, moure, rotar i fer captures de pantalla en 3D de l'òrgan cardíac i així, entendre millor la cardiopatia que s’ha de tractar. El resultat ha estat la creació d'un procés òptim, en el que la reconstrucció en 3D ha aconseguit ser ràpida i precisa, el mètode d’importació a l’app dissenyada molt senzill, i una aplicació que permet una interacció atractiva i intuïtiva, gracies a una experiència immersiva i realista per ajustar-se als requeriments d'eficiència i precisió exigits en el camp mèdic

Microscope Embedded Neurosurgical Training and Intraoperative System

In the recent years, neurosurgery has been strongly influenced by new technologies. Computer Aided Surgery (CAS) offers several benefits for patients\u27 safety but fine techniques targeted to obtain minimally invasive and traumatic treatments are required, since intra-operative false movements can be devastating, resulting in patients deaths. The precision of the surgical gesture is related both to accuracy of the available technological instruments and surgeon\u27s experience. In this frame, medical training is particularly important. From a technological point of view, the use of Virtual Reality (VR) for surgeon training and Augmented Reality (AR) for intra-operative treatments offer the best results. In addition, traditional techniques for training in surgery include the use of animals, phantoms and cadavers. The main limitation of these approaches is that live tissue has different properties from dead tissue and that animal anatomy is significantly different from the human. From the medical point of view, Low-Grade Gliomas (LGGs) are intrinsic brain tumours that typically occur in younger adults. The objective of related treatment is to remove as much of the tumour as possible while minimizing damage to the healthy brain. Pathological tissue may closely resemble normal brain parenchyma when looked at through the neurosurgical microscope. The tactile appreciation of the different consistency of the tumour compared to normal brain requires considerable experience on the part of the neurosurgeon and it is a vital point. The first part of this PhD thesis presents a system for realistic simulation (visual and haptic) of the spatula palpation of the LGG. This is the first prototype of a training system using VR, haptics and a real microscope for neurosurgery. This architecture can be also adapted for intra-operative purposes. In this instance, a surgeon needs the basic setup for the Image Guided Therapy (IGT) interventions: microscope, monitors and navigated surgical instruments. The same virtual environment can be AR rendered onto the microscope optics. The objective is to enhance the surgeon\u27s ability for a better intra-operative orientation by giving him a three-dimensional view and other information necessary for a safe navigation inside the patient. The last considerations have served as motivation for the second part of this work which has been devoted to improving a prototype of an AR stereoscopic microscope for neurosurgical interventions, developed in our institute in a previous work. A completely new software has been developed in order to reuse the microscope hardware, enhancing both rendering performances and usability. Since both AR and VR share the same platform, the system can be referred to as Mixed Reality System for neurosurgery. All the components are open source or at least based on a GPL license

Augmented reality system with application in physical rehabilitation

The aging phenomenon causes increased physiotherapy services requirements, with increased costs associated with long rehabilitation periods. Traditional rehabilitation methods rely on the subjective assessment of physiotherapists without supported training data. To overcome the shortcoming of traditional rehabilitation method and improve the efficiency of rehabilitation, AR (Augmented Reality) which represents a promissory technology that provides an immersive interaction with real and virtual objects is used. The AR devices may assure the capture body posture and scan the real environment that conducted to a growing number of AR applications focused on physical rehabilitation. In this MSc thesis, an AR platform used to materialize a physical rehabilitation plan for stroke patients is presented. Gait training is a significant part of physical rehabilitation for stroke patients. AR represents a promissory solution for training assessment providing information to the patients and physiotherapists about exercises to be done and the reached results. As part of MSc work an iOS application was developed in unity 3D platform. This application immersing patients in a mixed environment that combine real-world and virtual objects. The human computer interface is materialized by an iPhone as head-mounted 3D display and a set of wireless sensors for physiological and motion parameters measurement. The position and velocity of the patient are recorded by a smart carpet that includes capacitive sensors connected to a computation unit characterized by Wi-Fi communication capabilities. AR training scenario and the corresponding experimental results are part of the thesis.O envelhecimento causa um aumento das necessidades dos serviços de fisioterapia, com aumento dos custos associados a longos períodos de reabilitação. Os métodos tradicionais de reabilitação dependem da avaliação subjetiva de fisioterapeutas sem registo automatizado de dados de treino. Com o principal objetivo de superar os problemas do método tradicional e melhorar a eficiência da reabilitação, é utilizada a RA (Realidade Aumentada), que representa uma tecnologia promissora, que fornece uma interação imersiva com objetos reais e virtuais. Os dispositivos de RA são capazes de garantir uma postura correta do corpo de capturar e verificar o ambiente real, o que levou a um número crescente de aplicações de RA focados na reabilitação física. Neste projeto, é apresentada uma plataforma de RA, utilizada para materializar um plano de reabilitação física para pacientes que sofreram AVC. O treino de marcha é uma parte significativa da reabilitação física para pacientes com AVC. A RA apresenta-se como uma solução promissora para a avaliação do treino, fornecendo informações aos pacientes e aos profissionais de fisioterapia sobre os exercícios a serem realizados e os resultados alcançados. Como parte deste projeto, uma aplicação iOS foi desenvolvida na plataforma Unity 3D. Esta aplicação fornece aos pacientes um ambiente imersivo que combina objetos reais e virtuais. A interface de RA é materializada por um iPhone montado num suporte de cabeça do utilizador, assim como um conjunto de sensores sem fios para medição de parâmetros fisiológicos e de movimento. A posição e a velocidade do paciente são registadas por um tapete inteligente que inclui sensores capacitivos conectados a uma unidade de computação, caracterizada por comunicação via Wi-Fi. O cenário de treino em RA e os resultados experimentais correspondentes fazem parte desta dissertação

Intensive Driving Lesson System for Driving School

The focus of this project is to develop an Intensive Driving Lesson System for driving school that emphasize on aiding learning through 3D demonstration and interaction. The objectives of this project are to develop an intensive driving lesson system as a supplement to current driving lesson and JPJ's outline test, to incorporate the VR concept and giving information such as visualization in presenting the overviewof road driving scenarios to the students in the systemand to conduct a survey to evaluate system acceptance by the user. In order to achieve these objectives, the design method adopted to develop the system is based on Kulwinder Kaur's (1998). There are five (5) stages conducted in designing method; requirement analysis, task & domain analysis, design of VE, design of user support and navigation analysis and evaluation. The preliminary findings from the evaluation of the system showed that the completed system is able to compliment to the current driving lesson. Future recommendations and enhancements on the Intensive Driving Lesson system suggested that the use of 3D demonstration is refined further and implementation is applied with more details. The idea can be broaden by enhancing user navigation and interaction towards this features

Augmented reality (AR) for surgical robotic and autonomous systems: State of the art, challenges, and solutions

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human-robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future

Enhanced Concrete Bridge Assessment Using Artificial Intelligence and Mixed Reality

Conventional methods for visual assessment of civil infrastructures have certain limitations, such as subjectivity of the collected data, long inspection time, and high cost of labor. Although some new technologies (i.e. robotic techniques) that are currently in practice can collect objective, quantified data, the inspector\u27s own expertise is still critical in many instances since these technologies are not designed to work interactively with human inspector. This study aims to create a smart, human-centered method that offers significant contributions to infrastructure inspection, maintenance, management practice, and safety for the bridge owners. By developing a smart Mixed Reality (MR) framework, which can be integrated into a wearable holographic headset device, a bridge inspector, for example, can automatically analyze a certain defect such as a crack that he or she sees on an element, display its dimension information in real-time along with the condition state. Such systems can potentially decrease the time and cost of infrastructure inspections by accelerating essential tasks of the inspector such as defect measurement, condition assessment and data processing to management systems. The human centered artificial intelligence (AI) will help the inspector collect more quantified and objective data while incorporating inspector\u27s professional judgment. This study explains in detail the described system and related methodologies of implementing attention guided semi-supervised deep learning into mixed reality technology, which interacts with the human inspector during assessment. Thereby, the inspector and the AI will collaborate/communicate for improved visual inspection

Research on real-time physics-based deformation for haptic-enabled medical simulation

This study developed a multiple effective visuo-haptic surgical engine to handle a variety of surgical manipulations in real-time. Soft tissue models are based on biomechanical experiment and continuum mechanics for greater accuracy. Such models will increase the realism of future training systems and the VR/AR/MR implementations for the operating room

Contemporary Topics in Patient Safety

As healthcare systems continue to evolve, it is clear that providing safe, high-quality care to patients is an extremely complex process. Ranging from multi-disciplinary teams to bedside care, virtually every aspect of the patient-care experience provides us with an opportunity for doing things better, from improving efficiency, safety, and overall outcomes to reducing costs and promoting team synergy. This book, the fifth in our patient safety series collection, consists of chapters that help explore key concepts related to both the safety and quality of care. In a departure from the vignette-driven format of our earlier books, this installment gravitates toward discussing frameworks, theoretical considerations, team-centric approaches, and a variety of other concepts that are critical to both our understanding and the implementation of safer and better-performing health systems. We also feel that the knowledge presented herein increasingly applies across the world, especially as global health systems evolve and mature over time. It is our goal to improve the recognition of potential opportunities that will highlight various aspects of the delivery of healthcare and thus contribute to better patient experiences, with safety at the forefront. Topics covered in this volume, as well as the previous volumes, highlight the critical importance of identifying and addressing opportunities for improvement, not as one-time events, but rather as continuous, hardwired institutional processes