NaRALap: augmented reality system for navigation in laparoscopic surgery

The final publication is available at Springer via http://dx.doi.org/10.1007/s11548-011-0579-z.The AR system has a good resolution and currently is used for the placement of the trocars. Possible improvements will be performed to make the system independent of the camera position or to use natural marks. The biomechanical model and the AR algorithms will be combined with a tracker, for tracking the surgical instruments, in order to implement a valid system for liver biopsies. It will take into account the deformation due to the pneumoperitoneum and due to the breath of the patient. To develop the navigator that will guide the laparoscopic interventions, both AR system and biomechanical model will be combined with the laparoscopic camera in order to make an easier environment with only one vision in a 2D monitor.This work has been supported by the project MITYC (ref. TSI020100-2009-189). We would like to express our deep gratitude to the Hospital Clínica Benidorm for its participation in this project.López-Mir, F.; Martínez Martínez, F.; Fuertes Cebrián, JJ.; Lago, MA.; Rupérez Moreno, MJ.; Naranjo Ornedo, V.; Monserrat Aranda, C. (2011). NaRALap: augmented reality system for navigation in laparoscopic surgery. International Journal of Computer Assisted Radiology and Surgery. 6:98-99. https://doi.org/10.0.3.239/s11548-011-0579-zS9899

Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment) were involved in these experiments.The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery.This work has been supported by Centro para el Desarrollo Tecnologico Industrial (CDTI) under the project Oncotic (IDI-20101153) and the Hospital Clinica Benidorm(HCB) and partially supported by the Ministry of Education and Science of Spain (TIN2010-20999-C04-01), the project Consolider-C (SEJ2006-14301/PSIC) and the "CIBER of Physiopathology of Obesity Nutrition, an initiative of ISCIII" Prometheus and Excellence Research Program (Generalitat Valenciana, Department of Education, 2008-157). The authors would like to express their gratitude to the Hospital Clinica Benidorm and to the Hospital Univeritari i Politecnic la Fe (especially the surgical team) for their participation and involvement in this work.López-Mir, F.; Naranjo Ornedo, V.; Fuertes Cebrián, JJ.; Alcañiz Raya, ML.; Bueno, J.; Pareja, E. (2013). Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment. BioMed Research International. 2013:1-12. https://doi.org/10.1155/2013/758491S1122013Rowe, C. K., Pierce, M. W., Tecci, K. C., Houck, C. S., Mandell, J., Retik, A. B., & Nguyen, H. T. (2012). A Comparative Direct Cost Analysis of Pediatric Urologic Robot-Assisted Laparoscopic Surgery Versus Open Surgery: Could Robot-Assisted Surgery Be Less Expensive? Journal of Endourology, 26(7), 871-877. doi:10.1089/end.2011.0584Azuma, R. T. (1997). A Survey of Augmented Reality. Presence: Teleoperators and Virtual Environments, 6(4), 355-385. doi:10.1162/pres.1997.6.4.355Shuhaiber, J. H. (2004). Augmented Reality in Surgery. Archives of Surgery, 139(2), 170. doi:10.1001/archsurg.139.2.170Kersten-Oertel, M., Jannin, P., & Collins, D. L. (2012). DVV: A Taxonomy for Mixed Reality Visualization in Image Guided Surgery. IEEE Transactions on Visualization and Computer Graphics, 18(2), 332-352. doi:10.1109/tvcg.2011.50Cannon, J. W., Stoll, J. A., Selha, S. D., Dupont, P. E., Howe, R. D., & Torchiana, D. F. (2003). Port placement planning in robot-assisted coronary artery bypass. IEEE Transactions on Robotics and Automation, 19(5), 912-917. doi:10.1109/tra.2003.817502Adhami, L., & Coste-Manirei, E. (2003). Optimal planning for minimally invasive surgical robots. IEEE Transactions on Robotics and Automation, 19(5), 854-863. doi:10.1109/tra.2003.817061Bichlmeier, C., Heining, S. M., Feuerstein, M., & Navab, N. (2009). The Virtual Mirror: A New Interaction Paradigm for Augmented Reality Environments. IEEE Transactions on Medical Imaging, 28(9), 1498-1510. doi:10.1109/tmi.2009.2018622Feuerstein, M., Mussack, T., Heining, S. M., & Navab, N. (2008). Intraoperative Laparoscope Augmentation for Port Placement and Resection Planning in Minimally Invasive Liver Resection. IEEE Transactions on Medical Imaging, 27(3), 355-369. doi:10.1109/tmi.2007.907327Abdominal and Laparoscopic Surgery. (2010). International Journal of Computer Assisted Radiology and Surgery, 5(S1), 122-130. doi:10.1007/s11548-010-0446-3Ferrari, V., Megali, G., Troia, E., Pietrabissa, A., & Mosca, F. (2009). A 3-D Mixed-Reality System for Stereoscopic Visualization of Medical Dataset. IEEE Transactions on Biomedical Engineering, 56(11), 2627-2633. doi:10.1109/tbme.2009.2028013McSherry, C. K. (1989). Cholecystectomy: The gold standard. The American Journal of Surgery, 158(3), 174-178. doi:10.1016/0002-9610(89)90246-8Kum, C.-K., Eypasch, E., Aljaziri, A., & Troidl, H. (1996). Randomized comparison of pulmonary function after the ‘French’ and ‘American’ techniques of laparoscopic cholecystectomy. British Journal of Surgery, 83(7), 938-941. doi:10.1002/bjs.1800830716Mischkowski, R. A., Zinser, M. J., Kübler, A. C., Krug, B., Seifert, U., & Zöller, J. E. (2006). Application of an augmented reality tool for maxillary positioning in orthognathic surgery – A feasibility study. Journal of Cranio-Maxillofacial Surgery, 34(8), 478-483. doi:10.1016/j.jcms.2006.07.862Kawamata, T., Iseki, H., Shibasaki, T., & Hori, T. (2002). Endoscopic Augmented Reality Navigation System for Endonasal Transsphenoidal Surgery to Treat Pituitary Tumors: Technical Note. Neurosurgery, 50(6), 1393-1397. doi:10.1097/00006123-200206000-00038Vogt, S., Khamene, A., & Sauer, F. (2006). 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Diseño e implementación de un sistema de ayuda clínica para la realización de operaciones laparoscópicas mediante el uso de realidad aumentada

[EN] This work seeks the design and software development that consists of an Augmented Reality system to provide the surgeons with help when a keyhole surgery is being performed. Performance and accuracy validation are shown. ([ES] Este trabajo busca el diseño e implementación de un sistema de Realidad Aumentada para la asistencia en cirugía abdominal que permita la localización precisa de los puntos de inserción. Se analiza su funcionamiento y se valida la precisión obtenida.Fuertes Cebrián, JJ. (2013). Diseño e implementación de un sistema de ayuda clínica para la realización de operaciones laparoscópicas mediante el uso de realidad aumentada. http://hdl.handle.net/10251/43443Archivo delegad

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women