Assisted Surgery – Computer-, Robot-, Augmented- or Virtual-Reality-Assisted Surgery; Planning, 3D visualization_News & Media

Skip to contentAssisted SurgeryComputer-, Robot-, Augmented- or Virtual-Reality-Assisted Surgery; Planning, 3D visualizationMenuSurgical NavigationAugmented or Mixed RealityRobotic SurgeryPreoperative PlanningTechnologyVirtual RealityTrackingInstrumentImageRenderingImage RegistrationTracking of miniature-sized objects in 3D endoscopic visionChapter Tracking of Miniature-Sized Objects in 3D Endoscopic Vision Khanam Z., Raheja J.L. (2018) In: Das S., Chaki N. (eds) Algorithms and Applications. Smart Innovation, Systems and Technologies, vol 88. Springer, Singapore.Abstract:The advent of 3D endoscope has revolutionized the field of industrial and medical inspection. It allows visual examination of inaccessible areas like underground pipes and human cavity. Miniature-sized objects like kidney stone and industrial waste products like slags can easily be monitored using 3D endoscope. In this paper, we present a technique to track small objects in 3D endoscopic vision using feature detectors. The proposed methodology uses the input of the operator to segment the target in order to extract reliable and stable features. Grow-cut algorithm is used for interactive segmentation to segment the object in one of the frames and later on, sparse correspondence is performed using SURF feature detectors. SURF feature detection based tracking algorithm is extended to track the object in the stereo endoscopic frames. The evaluation of the proposed technique is done by quantitatively analyzing its performance in two ex vivo environment and subjecting the target to various conditions like deformation, change in illumination, and scale and rotation transformation due to movement of endoscope.Flow chart of proposed techniqueCarlos QuilesComputer-Assisted Surgery, TrackingLeave a commentApril 12, 20181 MinuteAutomated muscle segmentation from CT images of the hip and thigh using a hierarchical multi-atlas methodAutomated muscle segmentation from CT images of the hip and thigh using a hierarchical multi-atlas method Yokota, F., Otake, Y., Takao, M. et al. Int J CARS (2018).Abstract:PurposePatient-specific quantitative assessments of muscle mass and biomechanical musculoskeletal simulations require segmentation of the muscles from medical images. The objective of this work is to automate muscle segmentation from CT data of the hip and thigh.MethodWe propose a hierarchical multi-atlas method in which each hierarchy includes spatial normalization using simpler pre-segmented structures in order to reduce the inter-patient variability of more complex target structures.ResultsThe proposed hierarchical method was evaluated with 19 muscles from 20 CT images of the hip and thigh using the manual segmentation by expert orthopedic surgeons as ground truth. The average symmetric surface distance was significantly reduced in the proposed method (1.53 mm) in comparison with the conventional method (2.65 mm).ConclusionWe demonstrated that the proposed hierarchical multi-atlas method improved the accuracy of muscle segmentation from CT images, in which large inter-patient variability and insufficient contrast were involved.Carlos QuilesImage, Image ReconstructionLeave a commentApril 10, 20181 MinuteSpine pedicle screw placement using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3Open access preprint Thoracic, Lumbar, and Sacral Pedicle Screw Placement Using Stryker-Ziehm Virtual Screw Technology and Navigated Stryker Cordless Driver 3: Technical Note, by Satarasinghe et al. Preprints 2018.AbstractObject. Utilization of pedicle screws (PS) for spine stabilization is common in spinal surgery. With reliance on visual inspection of anatomical landmarks prior to screw placement, the free-hand technique requires a high level of surgeon skill and precision. Three-dimensional (3D) computer-assisted virtual neuronavigation improves the precision of PS placement and minimize steps. Methods. Twenty-three patients with degenerative, traumatic, or neoplastic pathologies received treatment via a novel three-step PS technique that utilizes a navigated power driver in combination with virtual screw technology. 1) Following visualization of neuroanatomy using intraoperative CT, a navigated 3-mm match stick drill bit was inserted at anatomical entry point with screen projection showing virtual screw. 2) Navigated Stryker Cordless Driver with appropriate tap was used to access vertebral body through pedicle with screen projection again showing virtual screw. 3) Navigated Stryker Cordless Driver with actual screw was used with screen projection showing the same virtual screw. One hundred and forty-four consecutive screws were inserted using this three-step, navigated driver, virtual screw technique. Results. Only 1 screw needed intraoperative revision after insertion using the three-step, navigated driver, virtual PS technique. This amounts to a 0.69% revision rate. One hundred percent of patients had intraoperative CT reconstructed images to confirm hardware placement. Conclusions. Pedicle screw placement utilizing the Stryker-Ziehm neuronavigation virtual screw technology with a three step, navigated power drill technique is safe and effective.Carlos QuilesComputer-Assisted SurgeryLeave a commentApril 10, 20181 MinuteDesign of smart tools to support pre- and intra-operative use of surgical navigation systemsDesign of smart tools to support pre- and intra-operative use of surgical navigation systems: Concepts of microcontroller-based display- and actuator-modules, by Gieseler et al. Technisches Messen (2018) published ahead of print.AbstractIn this paper we present novel solutions to support the application of computer assisted surgical interventions in which optical surgical navigation systems based on stereo cameras are used. The objective is to improve both the pre-operative setup and the intra-operative use of the navigation system. Following a short introduction describing the potential for improvements of existing navigation systems new approaches and the components to implement them are described. The pre-operative alignment of the stereo camera is made easier by attaching a small graphic display to its tripod which can show how much of the operating area is covered by the measurement volume of the camera. The intra-operative application is improved by a mechanism for motorized camera motions in order to follow the position of surgical instruments. Furthermore a small display can be attached to a surgical instrument which clearly indicates to the surgeon how to guide the instrument in order to stay on the planned trajectory.Mini-display (white) and RB (yellow) attached to a reamertool used for hip replacement surgery.Carlos QuilesComputer-Assisted SurgeryLeave a commentApril 10, 20181 MinuteVR training system for acquisition of surgical skillsOpen access Virtual Reality Training System for Anytime/Anywhere Acquisition of Surgical Skills: A Pilot Study, by Zahiri et al. Military Medicine (2018) 183(suppl_1):86–91.AbstractThis article presents a hardware/software simulation environment suitable for anytime/anywhere surgical skills training. It blends the advantages of physical hardware and task analogs with the flexibility of virtual environments. This is further enhanced by a web-based implementation of training feedback accessible to both trainees and trainers. Our training system provides a self-paced and interactive means to attain proficiency in basic tasks that could potentially be applied across a spectrum of trainees from first responder field medical personnel to physicians. This results in a powerful training tool for surgical skills acquisition relevant to helping injured warfighters.Carlos QuilesAugmented Reality, TrainingLeave a commentApril 10, 20180 MinutesRegistration of 3D freehand ultrasound to a bone model for orthopedic procedures of the forearmRegistration of 3D freehand ultrasound to a bone model for orthopedic procedures of the forearm, Ciganovic, M., Ozdemir, F., Pean, F. et al. Int J CARS (2018).AbstractPurposeFor guidance of orthopedic surgery, the registration of preoperative images and corresponding surgical plans with the surgical setting can be of great value. Ultrasound (US) is an ideal modality for surgical guidance, as it is non-ionizing, real time, easy to use, and requires minimal (magnetic/radiation) safety limitations. By extracting bone surfaces from 3D freehand US and registering these to preoperative bone models, complementary information from these modalities can be fused and presented in the surgical realm.MethodsA partial bone surface is extracted from US using phase symmetry and a factor graph-based approach. This is registered to the detailed 3D bone model, conventionally generated for preoperative planning, based on a proposed multi-initialization and surface-based scheme robust to partial surfaces.Results36 forearm US volumes acquired using a tracked US probe were independently registered to a 3D model of the radius, manually extracted from MRI. Given intraoperative time restrictions, a computationally efficient algorithm was determined based on a comparison of different approaches. For all 36 registrations, a mean (± SD) point-to-point surface distance of 0.57(±0.08)mm was obtained from manual gold standard US bone annotations (not used during the registration) to the 3D bone model.ConclusionsA registration framework based on the bone surface extraction from 3D freehand US and a subsequent fast, automatic surface alignment robust to single-sided view and large false-positive rates from US was shown to achieve registration accuracy feasible for practical orthopedic scenarios and a qualitative outcome indicating good visual image alignment.(left) Example registration results with US, MRI, and overlaid slices of corresponding locations with the proposed ICP-based alignment. (right) A tendon insertion (pronator teres) visible in US (top) is projected onto the 3D model (below) using the proposed ICP-based alignment, e.g., to facilitate preoperative planningCarlos QuilesImage, Image ReconstructionLeave a commentApril 10, 20181 MinuteCustomized 3D-printed drill guides for to assist pedicle and lateral mass screw insertionAccuracy Assessment of Pedicle and Lateral Mass Screw Insertion Assisted by Customized 3D-Printed Drill Guides: A Human Cadaver Study, by Pijpker et al.Operative Neurosurgery (2018).Abstract:BACKGROUNDAccurate cervical screw insertion is of paramount importance considering the risk of damage to adjacent vital structures. Recent research in 3-dimensional (3D) technology describes the advantage of patient-specific drill guides for accurate screw positioning, but consensus about the optimal guide design and the accuracy is lacking.OBJECTIVETo find the optimal design and to evaluate the accuracy of individualized 3D-printed drill guides for lateral mass and pedicle screw placement in the cervical and upper thoracic spine.METHODSFive Thiel-embalmed human cadavers were used for individualized drill-guide planning of 86 screw trajectories in the cervical and upper thoracic spine. Using 3D bone models reconstructed from acquired computed tomography scans, the drill guides were produced for both pedicle and lateral mass screw trajectories. During the study, the initial minimalistic design was refined, resulting in the advanced guide design. Screw trajectories were drilled and the realized trajectories were compared to the planned trajectories using 3D deviation analysis.RESULTSThe overall entry point and 3D angular accuracy were 0.76 ± 0.52 mm and 3.22 ± 2.34°, respectively. Average measurements for the minimalistic guides were 1.20 mm for entry points, 5.61° for the 3D angulation, 2.38° for the 2D axial angulation, and 4.80° for the 2D sagittal angulation. For the advanced guides, the respective measurements were 0.66 mm, 2.72°, 1.26°, and 2.12°, respectively.CONCLUSIONThe study ultimately resulted in an advanced guide design including caudally positioned hooks, crosslink support structure, and metal inlays. The novel advanced drill guide design yields excellent drilling accuracy.Carlos Quiles3D PrintingLeave a commentApril 10, 20181 Minute3D printing-based minimally invasive cannulated screw treatment of unstable pelvic fractureOpen access 3D printing-based minimally invasive cannulated screw treatment of unstable pelvic fracture, Cai, L., Zhang, Y., Chen, C. et al. J Orthop Surg Res (2018) 13: 71.Abstract: BackgroundOpen reduction and internal fixation of pelvic fractures could restore the stability of the pelvic ring, but there were several problems. Minimally invasive closed reduction cannulated screw treatment of pelvic fractures has lots advantages. However, how to insert the cannulated screw safely and effectively to achieve a reliable fixation were still hard for orthopedist. Our aim was to explore the significance of 3D printing technology as a new method for minimally invasive cannulated screw treatment of unstable pelvic fracture.MethodsOne hundred thirty-seven patients with unstable pelvic fractures from 2014 to 2016 were retrospectively analyzed. Based on the usage of 3D printing technology for preoperative simulation surgery, they were assigned to 3D printing group (n = 65) and control group (n = 72), respectively. These two groups were assessed in terms of operative time, intraoperative fluoroscopy, postoperative reduction effect, fracture healing time, and follow-up function. The effect of 3D printing technology was evaluated through minimally invasive cannulated screw treatment.ResultsThere was no significant difference in these two groups with respect to general conditions, such as age, gender, fracture type, time from injury to operation, injury cause, and combined injury. Length of surgery and average number of fluoroscopies were statistically different for 3D printing group and the control group (p