Surface reconstruction for planning and navigation of liver resections

AbstractComputer-assisted systems for planning and navigation of liver resection procedures rely on the use of patient-specific 3D geometric models obtained from computed tomography. In this work, we propose the application of Poisson surface reconstruction (PSR) to obtain 3D models of the liver surface with applications to planning and navigation of liver surgery. In order to apply PSR, the introduction of an efficient transformation of the segmentation data, based on computation of gradient fields, is proposed. One of the advantages of PSR is that it requires only one control parameter, allowing the process to be fully automatic once the optimal value is estimated. Validation of our results is performed via comparison with 3D models obtained by state-of-art Marching Cubes incorporating Laplacian smoothing and decimation (MCSD). Our results show that PSR provides smooth liver models with better accuracy/complexity trade-off than those obtained by MCSD. After estimating the optimal parameter, automatic reconstruction of liver surfaces using PSR is achieved keeping similar processing time as MCSD. Models from this automatic approach show an average reduction of 79.59% of the polygons compared to the MCSD models presenting similar smoothness properties. Concerning visual quality, on one hand, and despite this reduction in polygons, clinicians perceive the quality of automatic PSR models to be the same as complex MCSD models. On the other hand, clinicians perceive a significant improvement on visual quality for automatic PSR models compared to optimal (obtained in terms of accuracy/complexity) MCSD models. The median reconstruction error using automatic PSR was as low as 1.03±0.23mm, which makes the method suitable for clinical applications. Automatic PSR is currently employed at Oslo University Hospital to obtain patient-specific liver models in selected patients undergoing laparoscopic liver resection

Reproducibility in the absence of selective reporting: An illustration from large‐scale brain asymmetry research

The problem of poor reproducibility of scientific findings has received much attention over recent years, in a variety of fields including psychology and neuroscience. The problem has been partly attributed to publication bias and unwanted practices such as p‐hacking. Low statistical power in individual studies is also understood to be an important factor. In a recent multisite collaborative study, we mapped brain anatomical left–right asymmetries for regional measures of surface area and cortical thickness, in 99 MRI datasets from around the world, for a total of over 17,000 participants. In the present study, we revisited these hemispheric effects from the perspective of reproducibility. Within each dataset, we considered that an effect had been reproduced when it matched the meta‐analytic effect from the 98 other datasets, in terms of effect direction and significance threshold. In this sense, the results within each dataset were viewed as coming from separate studies in an “ideal publishing environment,” that is, free from selective reporting and p hacking. We found an average reproducibility rate of 63.2% (SD = 22.9%, min = 22.2%, max = 97.0%). As expected, reproducibility was higher for larger effects and in larger datasets. Reproducibility was not obviously related to the age of participants, scanner field strength, FreeSurfer software version, cortical regional measurement reliability, or regional size. These findings constitute an empirical illustration of reproducibility in the absence of publication bias or p hacking, when assessing realistic biological effects in heterogeneous neuroscience data, and given typically‐used sample sizes

Variational based smoke removal in laparoscopic images

Background In laparoscopic surgery, image quality can be severely degraded by surgical smoke, which not only introduces errors for the image processing algorithms (used in image guided surgery), but also reduces the visibility of the observed organs and tissues. To overcome these drawbacks, this work aims to remove smoke in laparoscopic images using an image preprocessing method based on a variational approach. Methods In this paper, we present the physical smoke model where the degraded image is separated into two parts: direct attenuation and smoke veil and propose an efficient variational-based desmoking method for laparoscopic images. To estimate the smoke veil, the proposed method relies on the observation that smoke veil has low contrast and low inter-channel differences. A cost function is defined based on this prior knowledge and is solved using an augmented Lagrangian method. The obtained smoke veil is then subtracted from the original degraded image, resulting in the direct attenuation part. Finally, the smoke free image is computed using a linear intensity transformation of the direct attenuation part. Results The performance of the proposed method is evaluated quantitatively and qualitatively using three datasets: two public real smoked laparoscopic datasets and one generated synthetic dataset. No-reference and reduced-reference image quality assessment metrics are used with the two real datasets, and show that the proposed method outperforms the state-of-the-art ones. Besides, standard full-reference ones are employed with the synthetic dataset, and indicate also the good performance of the proposed method. Furthermore, the qualitative visual inspection of the results shows that our method removes smoke effectively from the laparoscopic images. Conclusion All the obtained results show that the proposed approach reduces the smoke effectively while preserving the important perceptual information of the image. This allows to provide a better visualization of the operation field for surgeons and improve the image guided laparoscopic surgery procedure

Automatic programming of grinding robot

A new programming method is developed for grinding robots. Instead of using the conventional jog-and-teach method, the workpiecc geometry is automatically scanned by a contour tracking system. During tracking of the workpiece contour, the robot position is continuously logged. Finally a robot program is automatically generated

Process model analysis of parenchyma sparing laparoscopic liver surgery to recognize surgical steps and predict impact of new technologies

Background: Surgical process model (SPM) analysis is a great means to predict the surgical steps in a procedure as well as to predict the potential impact of new technologies. Especially in complicated and high-volume treatments, such as parenchyma sparing laparoscopic liver resection (LLR), profound process knowledge is essential for enabling improving surgical quality and efficiency. Methods: Videos of thirteen parenchyma sparing LLR were analyzed to extract the duration and sequence of surgical steps according to the process model. The videos were categorized into three groups, based on the tumor locations. Next, a detailed discrete events simulation model (DESM) of LLR was built, based on the process model and the process data obtained from the endoscopic videos. Furthermore, the impact of using a navigation platform on the total duration of the LLR was studied with the simulation model by assessing three different scenarios: (i) no navigation platform, (ii) conservative positive effect, and (iii) optimistic positive effect. Results: The possible variations of sequences of surgical steps in performing parenchyma sparing depending on the tumor locations were established. The statistically most probable chain of surgical steps was predicted, which could be used to improve parenchyma sparing surgeries. In all three categories (i–iii) the treatment phase covered the major part (~ 40%) of the total procedure duration (bottleneck). The simulation results predict that a navigation platform could decrease the total surgery duration by up to 30%. Conclusion: This study showed a DESM based on the analysis of steps during surgical procedures can be used to predict the impact of new technology. SPMs can be used to detect, e.g., the most probable workflow paths which enables predicting next surgical steps, improving surgical training systems, and analyzing surgical performance. Moreover, it provides insight into the points for improvement and bottlenecks in the surgical process.Medical Instruments & Bio-Inspired Technolog

Generic surgical process model for minimally invasive liver treatment methods

Surgical process modelling is an innovative approach that aims to simplify the challenges involved in improving surgeries through quantitative analysis of a well-established model of surgical activities. In this paper, surgical process model strategies are applied for the analysis of different Minimally Invasive Liver Treatments (MILTs), including ablation and surgical resection of the liver lesions. Moreover, a generic surgical process model for these differences in MILTs is introduced. The generic surgical process model was established at three different granularity levels. The generic process model, encompassing thirteen phases, was verified against videos of MILT procedures and interviews with surgeons. The established model covers all the surgical and interventional activities and the connections between them and provides a foundation for extensive quantitative analysis and simulations of MILT procedures for improving computer-assisted surgery systems, surgeon training and evaluation, surgeon guidance and planning systems and evaluation of new technologies

Generic surgical process model for minimally invasive liver treatment methods

Surgical process modelling is an innovative approach that aims to simplify the challenges involved in improving surgeries through quantitative analysis of a well-established model of surgical activities. In this paper, surgical process model strategies are applied for the analysis of different Minimally Invasive Liver Treatments (MILTs), including ablation and surgical resection of the liver lesions. Moreover, a generic surgical process model for these differences in MILTs is introduced. The generic surgical process model was established at three different granularity levels. The generic process model, encompassing thirteen phases, was verified against videos of MILT procedures and interviews with surgeons. The established model covers all the surgical and interventional activities and the connections between them and provides a foundation for extensive quantitative analysis and simulations of MILT procedures for improving computer-assisted surgery systems, surgeon training and evaluation, surgeon guidance and planning systems and evaluation of new technologies.Medical Instruments & Bio-Inspired Technolog