Laparoscopic image analysis for automatic tracking of surgical tools

Laparoscopy is a surgical technique nowadays embedded in the clinical routine. Recent researches have been focused on analysing video information captured by the endoscope for extracting cues useful for surgeons, such as depth information. In particular, the 3D pose estimation of the surgical tools presents three important added values: (1) to extract objective parameters for the surgical training stage, (2) to develop an image-guided surgery based on the knowledge of the surgery tools localization, (3) to design new roboticsystems for an automatic laparoscope positioning, according to the visual feedback. Tool’s shape and orientation in the image is the key to get its 3D position. This work presents an image analysis for automatic laparoscopic tool’s detection along the recorded video without extra tool markers, using an edges detection strategy. Also, this analysis includes a previous stage of barrel distortion correction for videoendoscopic image

Segmentation and 3D reconstruction approaches for the design of laparoscopic augmented reality environments

A trend in abdominal surgery is the transition from minimally invasive surgery to surgeries where augmented reality is used. Endoscopic video images are proposed to be employed for extracting useful information to help surgeons performing the operating techniques. This work introduces an illumination model into the design of automatic segmentation algorithms and 3D reconstruction methods. Results obtained from the implementation of our methods to real images are supposed to be an initial step useful for designing new methodologies that will help surgeons operating MIS techniques

Cálculo e interpretación del coeficiente de correlación lineal

El objeto matemático a enseñar es el coeficiente de correlación, cuyos aspectos a tratar son: definición y propiedades, significado y aspectos interpretativos junto con sus aplicaciones. Esta propuesta de enseñanza se fundamenta en tres aspectos diferenciadores: 1) Aprendizaje de la estadística mediante proyectos 2) Problemas con contextos reales 3) Evaluación cooperativ

Laparoscopic tool tracking method for augmented reality surgical applications

Vision-based tracking of laparoscopic tools offers new possibilities for improving surgical training and for developing new augmented reality surgical applications. We present an original method to determine not only the tip position, but also the orientation of a laparoscopic tool respect to the camera coordinate frame. A simple mathematical formulation shows how segmented tool edges and camera field of view define the tool 3D orientation. Then, 3D position of the tool tip is determined by image 2D coordinates of any known point of the tool and by tool’s diameter. Accuracy is evaluated in real image sequences with known ground truth. Results show a positioning error of 9,28 mmRMS, what is explained by inaccuracies in the estimation of tool edges. The main advantage of proposed method is its robustness to occlusions of the tool tip

Segmentación y seguimiento de estructuras en imágenes laparoscópicas

La estimación de la posición 3D de las diferentes estructuras que aparecen en cirugía laparoscópica es una medida de gran importancia para el desarrollo de aplicaciones para la formación y aprendizaje de futuros cirujanos. Para dicha estimación se hace necesaria una etapa previa de segmentación de estructuras y de seguimiento de las mismas a lo largo de la secuencia de imágenes que compone la intervención. En este trabajo de investigación se propone un método de segmentación semiautomática basada en la combinación de sobresegmentación y crecimiento de regiones y un algoritmo de seguimiento de la estructura segmentada. Para el desarrollo de estos algoritmos se utilizan técnicas de tratamiento de imágenes junto con métodos basados en la estadística paramétrica y no paramétrica

Optimización de un método de detección y seguimiento de instrumental quirúrgico en video laparoscópico

La localización del instrumental quirúrgico es de gran interés en Cirugía Mínimamente Invasiva (CMI). Determinar su posición con precisión es fundamental para el desarrollo de futuras aplicaciones tanto en la formación y evaluación de cirujanos como en el desarrollo de nuevos sistemas de navegación que asistan al cirujano durante la propia intervención quirúrgica. En la literatura existen técnicas de estimación basadas en el análisis de imágenes, siendo la principal limitación común la gran variabilidad de las imágenes de este tipo de cirugía, que dificultan el diseño de un método genérico capaz de obtener buenas precisiones para todas ellas. En este trabajo de investigación se propone una optimización de un método de detección y seguimiento automático de instrumental quirúrgico basado en el análisis de video endoscópico, incorporando filtros homomórficos, un nuevo algoritmo de segmentación y un seguimiento mediante enventanado. Los resultados obtenidos muestran que el método propuesto consigue una detección precisa y robusta para imágenes con diferentes características sin necesidad de ninguna adaptación previa

Editor multimedia de vídeo laparoscópico para formación de habilidades cognitivas

La cirugía de mínima invasión (CMI) es un tipo de cirugía que, dado el elevado número de ventajas que presenta frente a la cirugía abierta tradicional, está siendo cada vez más utilizada en los centros hospitalarios de todo el mundo. Sin embargo, su inconveniente principal es que requiere la adquisición de nuevas habilidades motoras y cognitivas. Es en el terreno de las habilidades cognitivas, donde cobra especial interés la formación mediante los vídeos quirúrgicos, principal fuente de información de las intervenciones de CMI. Este trabajo aborda el diseño e implementación de un editor multimedia de vídeo laparoscópico capaz de añadir información útil a los vídeos originales, ofreciendo al usuario una serie de funcionalidades, con el fin de ayudar a la formación de los cirujanos. La validación llevada a cabo muestra cómo el usuario no sólo considera la herramienta aquí presentada de gran utilidad, sino también usable

Biscay AGL. An observatory for state of the art operational oceanography at IEO. Derived products, sensor networks and future developments.

Since 1991, shelf and slope waters of the Southern Bay of Biscay are regularly sampled in a monthly hydrographical section north of Santander. From 2003, a deep hydrological standard section was included and on June 2007, an ocean-meteorological buoy was moored at the end of Santander Section (www.boya_agl.st.ieo.es). All of three are part of IEOOS (IEO Observing System). Biscay AGL is one observatory for the EU FixO3 project. The combination of these resources leads to a powerful tool, Biscay AGL, which is more than the combination of the AGL Buoy and the hydrographical samplings. This tool produces not only time series of several parameters at different time resolutions but also derived products, both real and delayed time. Derived products from this buoy include, annual cycles as well as anomalous values. In particular ones such as air-sea heat fluxes, salinity and water temperatures anomalies, sub inertial currents series, chlorophyll surface series, estimate of the mixed layer depth and wind and currents roses. Many sensor networks have been deployed to monitor marine environment, and more will follow in the future. Due to the large number of sensor manufacturers, integrating diverse sensors into observation systems is not straightforward. By defining standardized service interfaces it is possible to enable access to sensor networks and archived sensor data that can be discovered and accessed using standard protocols and application programming interfaces. Future developments include the deployment of a full sensor network as well as adding new devices to the Biscay AGL tool in order to achieve deeper knowledge of the ocean

MAB-MIG: registry of the spanish neurological society of erenumab for migraine prevention

Erenumab; Migranya; Anticòs monoclonalErenumab; Migraña; Anticuerpo monoclonalErenumab; Migraine; Monoclonal antibodyBackground Erenumab was approved in Europe for migraine prevention in patients with ≥ 4 monthly migraine days (MMDs). In Spain, Novartis started a personalized managed access program, which allowed free access to erenumab before official reimbursement. The Spanish Neurological Society started a prospective registry to evaluate real-world effectiveness and tolerability, and all Spanish headache experts were invited to participate. We present their first results. Methods Patients fulfilled the ICHD-3 criteria for migraine and had ≥ 4 MMDs. Sociodemographic and clinical data were registered as well as MMDs, monthly headache days, MHDs, prior and concomitant preventive treatment, medication overuse headache (MOH), migraine evolution, adverse events, and patient-reported outcomes (PROs): headache impact test (HIT-6), migraine disability assessment questionnaire (MIDAS), and patient global improvement change (PGIC). A > 50% reduction of MMDs after 12 weeks was considered as a response. Results We included 210 patients (female 86.7%, mean age 46.4 years old) from 22 Spanish hospitals from February 2019 to June 2020. Most patients (89.5%) suffered from chronic migraine with a mean evolution of 8.6 years. MOH was present in 70% of patients, and 17.1% had migraine with aura. Patients had failed a mean of 7.8 preventive treatments at baseline (botulinum toxin type A—BoNT/A—had been used by 95.2% of patients). Most patients (67.6%) started with erenumab 70 mg. Sixty-one percent of patients were also simultaneously taking oral preventive drugs and 27.6% were getting simultaneous BoNT/A. Responder rate was 37.1% and the mean reduction of MMDs and MHDs was -6.28 and -8.6, respectively. Changes in PROs were: MIDAS: -35 points, HIT-6: -11.6 points, PIGC: 4.7 points. Predictors of good response were prior HIT-6 score < 80 points (p = 0.01), ≤ 5 prior preventive treatment failures (p = 0.026), absence of MOH (p = 0.039), and simultaneous BoNT/A treatment (p < 0.001). Twenty percent of patients had an adverse event, but only two of them were severe (0.9%), which led to treatment discontinuation. Mild constipation was the most frequent adverse event (8.1%). Conclusions In real-life, in a personalized managed access program, erenumab shows a good effectiveness profile and an excellent tolerability in migraine prevention in our cohort of refractory patients.We declare that we have not received any scholarship, nor grant, nor help to do the MAB-MIG registry