Background: Minimally invasive surgery creates two technological opportunities: (1) the development of better training and objective evaluation environments, and (2) the creation of image guided surgical systems

Gómez Aguilera, Enrique J.

Oropesa García, Ignacio

Sánchez González, Patricia

Servicio de Coordinación de Bibliotecas de la Universidad Politécnica de Madrid

10 SEIQ abstracts
path length, showing a strong correlation with needle position. Needle position
and driving also related to economy of area and economy of volume.
Conclusions: There is a correlation between checklist score and the tool’s
motion analysis metrics.
CHANGING THE PARADIGM: ENDOSCOPIC VIDEO ANALYSIS AND
INFORMATION EXTRACTION FOR SAFER SURGERIES
P. Sa´nchez-Gonza´lez1,2, I. Oropesa1,2, E.J. Go´mez1,2
1Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicacio´n,
Universidad Polite´cnica de Madrid, Madrid, Spain, 2Biomedical Research Networking
Center in Bioengineering, Biomaterials and Nanomedicine, Madrid, Spain
Background: Minimally invasive surgery creates two technological oppor-
tunities: (1) the development of better training and objective evaluation
environments, and (2) the creation of image guided surgical systems.
Methods: Surgical video processing algorithms have been developed and
validated to provide useful information about the surgical scenes and
with the following goals: (1)segmentation and tracking of structures, (2)3D
reconstruction for the acquisition of the depth map of the surgical scene and
(3)trocars and endoscope 3D tracking.
Results: Video analysis algorithms have led to the development of three
environments focused on (1) cognitive skills’ training (TELMA environment),
(2) objective assessment (EVA tracking system) and (3) soft-tissue surgical
navigation (THEMIS liver image and video navigation environment).
Conclusions: Video processing is presented as a solution to obtain useful
surgical information allowing the localization and tracking of the elements
and the 3D reconstruction of the anatomical scenario, in a non-intrusive way
during the procedure.
INTRAOPERATIVE IMAGING IN NEUROSURGERY: INITIAL EXPERI-
ENCE WITH CT-SCAN IN DEEP BRAIN STIMULATION AND SPINE
SURGERY
I. Pomposo1,2, E. Ruiz de Gopegui1, G. Bilbao1,2, G. Carbayo1,
L. Galbarriatu1, I. Garcı´a-Alonso2
1Neurosurgery Department, Cruces University Hospital, Barakaldo, Spain. 2Dpt.
of Surgery, Radiology and Physical Medicine, The Basque Country University
UPV/EHU, Leioa, Spain
Background: Intraoperative imaging technologies have an ever-increasing
role in surgery. The O-Arm (Medtronic intraoperative CT-scan) provides
multidimensional images suitable for the neuronavigation station. The
effectiveness of deep brain stimulation (DBS) and spine surgery depends on
the accuracy of the location of electrodes and ostheosynthesis implants.
Methods: A 1-year prospective compilation of patients operated on with the
use of O-Arm has been performed in Cruces University Hospital.
Results: DBS: we have operated on 13 patients. Patient positioning adjusted
to the O-arm requires a learning curve. Hypothesis previously made by
microelectrode recording is confirmed in most of the cases. It also has been
useful for decision-making. Spine surgery: we have operated on 74 patients
and issues that affect overall surgery time are related to system positioning,
operating table or surgical instruments.
Conclusions: We report here our early experiences with the O-arm in spine
surgery and DBS. In order to overcome initial difficulties a suitable training is
essential.
ISOLATED TRICUSPID VALVE SURGERY WITH NORMOFUNCTIONING
LEFT SIDE. THE END-STAGE RHEUMATIC HEART VALVE DISEASE
L. Diez-Solorzano, V. Tasco´n, J. M. Bernal
Cardiovascular Surgery, Hospital Universitario Valdecilla, Universidad de Cantabria,
Santander, Spain
Background: The aim of this study was to compare early and long-term
results in patients who underwent either isolated repair or replacement of the
tricuspid valve with normofunctioning left side valves.
Methods: Forty-seven patients underwent tricuspid valve replacement (TVR)
(n= 29, 61.7%) or repair (TVr) (n= 18, 38.3%). Patients undergoing TVR had
the same tricuspid regurgitation (TR) degree: 3.57 versus 3.55.
Results: Hospital mortality was 8 patients (17.0%) and was higher among
patients of the TVR group (27.6%) than in TVr group (0.0%) (p= .01).
Actuarial survival curve was 30.7± 9.4% at 10 years and null at 20 years for
TVR group. For TVr group, actuarial survival curve was 58.6± 12.1% at 10
years and 32.6± 15.3% at 20 years. Comparison between both groups shows
statistical significant differences (p= 0.011).
Conclusions: Patients who required an isolated tricuspid valve surgery with
normofunctioning lefts side valves have a significantly high early and long-term
mortality due to cardiac and valvular causes. This bad prognosis is even worse
for those patients who required a tricuspid valve replacement comparing with
those who underwent a valve repair.
MITRALANDTRICUSPIDVALVEREPAIRWITHDURANFLEXIBLERING
ANNULOPLASTY
L. Diez-Solorzano, J. M. Bernal
Cardiovascular Surgery, Hospital Universitario Valdecilla, Universidad de Cantabria,
Santander, Spain
Objectives: We examined predictors of early and very long-term outcome
after combinedmitral and tricuspid valve repair with a flexible ring for rheumatic
disease.
Methods: Between 1974 and 1999, 122 consecutive patients (mean age,
45.1± 12.5 years) underwent combined mitral and tricuspid valve annuloplasty
with a flexible ring. Mitral repair included commissurotomy associated with
a flexible annuloplasty in 98 (80.3%), and isolated flexible annuloplasty in 24
(19.7%). Tricuspid valve repair included flexible annuloplasty in 44 patients
(36.1%) and annuloplasty combined with tricuspid commissurotomy in 78
patients (63.9%).
Results: Thirty-day mortality was 4.8%. Predictors of early mortality were
previous mitral closed commisurotomy, postclamping time and reoperation for
bleeding. Late mortality was 94 patients (77.1%) and the main cause was cardiac
failure. Forty-six (37.7%) patients required valve reoperation, and 31 of them
(67.4%) had been for progression of rheumatic valvular disease.
Conclusions: Combined mitral and tricuspid valve repair with a flexible ring
in rheumatic disease showed satisfactory early results. Long-term results were
poor because of high mortality and a high number of valve-related reoperations.
The use of prosthetic ring annuloplasty was associated with a reduced incidence
of both mitral and tricuspid valve reoperations.
EVALUATION OF POSTOPERATIVE LUNG FUNCTION AND THORACIC
PAIN IN PATIENTS WITH DIFFERENT METHODS OF STERNAL
CLOSURE
A. D. Jime´nez-Ramos1, J. L. Herna´ndez1, M. D. Moronta2, R. M.
Caicedo2, B. Carrillo2, I. Valverde2, A. Rodero2, M. A. Rubio1; R. de
Miguel1
1Departments of Cardiac Surgery and Pneumology, 2(Functional Explorations),
Hospital Militar Central de la Defensa ‘‘Go´mez Ulla’’, Madrid, SPAIN
Purpose: Comparing results of postoperative pain and ventilation parameters
in patients undergoing sternal closure with nitinol clips versus patients with
classic steelwire suture.
Methods: 140 heart surgery patients were randomized in groups performing
sternal closure by steel wires suture or by nitinol clips. Both groups were
comparable for sternal dehiscence risk. Spirometry and diffusion tests were
performed pre and early postoperative and studied bymeans of pre/postoperative
decremental percentages. Postoperative thoracic pain was also evaluated
(absent= 0, maximum= 5).
Results: Deceased patients (n= 7) and prolonged mechanical ventilation and
mediastinitis cases were excluded. Pain evaluation was better in nitinol group
(2.5± 0.8) thanwires group (3.7± 1.8). Both inspiratory and total lung capacities
decrease less in group 1 than in group 0.Neither FEV1 nor diffusion test showed
differences between groups.
 2014 BJS Society Ltd www.bjs.co.uk BJS 2014; 101 (Suppl. 1): 1–14
Published by John Wiley & Sons Ltd


Changing the paradigm: endoscopic video analysis and information extraction for safer surgeries

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http://oa.upm.es/26181/1/INVE_MEM_2013_162899.pdf

Changing the paradigm: endoscopic video analysis and information extraction for safer surgeries

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