The international journal of medical robotics + computer assisted surgery : MRCAS最新文献

Background and aim: Most of the Mixed Reality models used in the surgical telepresence are suffering from the discrepancies in the boundary area and spatial-temporal inconsistency due to the illumination variation in the video frames. The aim behind this work is to propose a new solution that helps produce the composite video by merging the augmented video of the surgery site and virtual hand of the remote expertise surgeon. The purpose of the proposed solution is to decrease the processing time and enhance the accuracy of merged video by decreasing the overlay and visualization error and removing occlusion and artefacts.

Methodology: The proposed system enhanced the mean value cloning algorithm that helps to maintain the spatial-temporal consistency of the final composite video. The enhanced algorithm includes the 3D mean value coordinates and improvised mean value interpolant in the image cloning process, which helps to reduce the sawtooth, smudging and discoloration artefacts around the blending region RESULTS: As compared to the state of art solution, the accuracy in terms of overlay error of the proposed solution is improved from 1.01mm to 0.80mm whereas the accuracy in terms of visualization error is improved from 98.8% to 99.4%. The processing time is reduced to 0.173 seconds from 0.211 seconds CONCLUSION: Our solution helps make the object of interest consistent with the light intensity of the target image by adding the space distance that helps maintain the spatial consistency in the final merged video. This article is protected by copyright. All rights reserved.

Background and aim: Image registration and alignment are the main limitations of augmented reality-based knee replacement surgery. This research aims to decrease the registration error, eliminate outcomes that are trapped in local minima to improve the alignment problems, handle the occlusion and maximize the overlapping parts.

Methodology: markerless image registration method was used for Augmented reality-based knee replacement surgery to guide and visualize the surgical operation. While weight least square algorithm was used to enhance stereo camera-based tracking by filling border occlusion in right to left direction and non-border occlusion from left to right direction.

Results: This study has improved video precision to 0.57 mm ∼ 0.61 mm alignment error. Furthermore, with the use of bidirectional points, i.e. Forwards and backwards directional cloud point, the iteration on image registration was decreased. This has led to improved the processing time as well. The processing time of video frames was improved to 7.4 ∼11.74 fps.

Conclusions: It seems clear that this proposed system has focused on overcoming the misalignment difficulty caused by movement of patient and enhancing the AR visualization during knee replacement surgery. The proposed system was reliable and favourable which helps in eliminating alignment error by ascertaining the optimal rigid transformation between two cloud points and removing the outliers and non-Gaussian noise. The proposed augmented reality system helps in accurate visualization and navigation of anatomy of knee such as femur, tibia, cartilage, blood vessels, etc. This article is protected by copyright. All rights reserved.

Background: Traditional fracture reduction surgery cannot ensure the accuracy of the reduction while consuming the physical strength of the surgeon. Although monitoring the fracture reduction process through radiography can improve the accuracy of the reduction, it will bring radiation harm to both patients and surgeons.

Methods: We proposed a novel fracture reduction solution that parallel robot is used for fracture reduction surgery. The binocular camera indirectly obtains the position and posture of the fragment wrapped by the tissue by measuring the posture of the external markers. According to the clinical experience of fracture reduction, a path is designed for fracture reduction. Then using position-based visual serving control the robot to fracture reduction surgery. The study is approved by the Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids, Beijing , China.

Results: 10 virtual cases of fracture were used for fracture reduction experiments. The simulation and model bone experiments are designed respectively. In model bone experiments, the fragments are reduction without collision. The angulation error after the reduction of this method is:3.3°±1.8°, and the axial rotation error is 0.8°±0.3°, the transverse stagger error and the axial direction error after reduction is 2mm±0.5mm and 2.5mm±1mm. After the reduction surgery, the external fixator is used to assist the fixing, and the deformity will be completely corrected.

Conclusions: The solution can perform fracture reduction surgery with certain accuracy and effectively reduce the number of radiographic uses during surgery, and the collision between fragments is avoided during surgery. This article is protected by copyright. All rights reserved.

Background: The objective of this study was to evaluate the safety and feasibility of robot-assisted thoracoscopic surgery (RATS).

Methods: From May 2009 to May 2013, 48 patients with intrathoracic lesions underwent RATS with the da Vinci® Surgical System was reported (11 lobectomies, 37 mediastinal tumour resections).

Results: RATS was successfully and safely completed in all 48 patients. Conversion of the operation to open surgery was not needed in any patient. The average operation time was 85.9 min, average blood loss 33 ml, and average hospital stay 3.9 days. No patient required blood transfusion. The only recognized adverse event was the development of a bronchopleural fistula in one patient.

Conclusions: RATS appears feasible and safe in thoracic surgery. More investigation will be needed in order to determine its possible long-term benefits and cost effectiveness.

Background: Femoral tunnel positioning is a difficult, but important factor in successful anterior cruciate ligament (ACL) reconstruction. Computer navigation can improve the anatomical planning procedure besides the tunnel placement procedure.

Methods: The accuracy of the computer-assisted femoral tunnel positioning method for anatomical double bundle ACL-reconstruction with a three-dimensional template was determined with respect to both aspects for AM and PL bundles in 12 cadaveric knees.

Results: The accuracy of the total tunnel positioning procedure was 2.7 mm (AM) and 3.2 mm (PL). These values consisted of the accuracies for planning (AM:2.9 mm; PL:3.2 mm) and for placement (about 0.4 mm). The template showed a systematic bias for the PL-position.

Conclusions: The computer-assisted templating method showed high accuracy for tunnel placement and has promising capacity for application in anatomical tunnel planning. Improvement of the template will result in an accurate and robust navigation system for femoral tunnel positioning in ACL-reconstruction.

Background: High-frequency electricity is used in the majority of surgical interventions. However, modern computer-based training and simulation systems rely on physically unrealistic models that fail to capture the interplay of the electrical, mechanical and thermal properties of biological tissue.

Methods: We present a real-time and physically realistic simulation of electrosurgery by modelling the electrical, thermal and mechanical properties as three iteratively solved finite element models. To provide subfinite-element graphical rendering of vaporized tissue, a dual-mesh dynamic triangulation algorithm based on isotherms is proposed. The block compressed row storage (BCRS) structure is shown to be critical in allowing computationally efficient changes in the tissue topology due to vaporization.

Results: We have demonstrated our physics-based electrosurgery cutting algorithm through various examples. Our matrix manipulation algorithms designed for topology changes have shown low computational cost.

Conclusions: Our simulator offers substantially greater physical fidelity compared to previous simulators that use simple geometry-based heat characterization.

Background: There is scanty experience concerning robot-assisted Ivor-Lewis oesophagectomy, so every new experience is helpful.

Methods: We describe the techniques and short-term results of Ivor-Lewis oesophagectomy using a laparoscopic approach and robot-assisted thoracoscopy, and an observational study of prospective surveillance of the first 14 patients treated for oesophageal cancer. A gastric tube was created laparoscopically. Oesophagectomy was performed through a robot-assisted thoracoscopy followed by hand-sewn intrathoracic anastomosis.

Results: There were no conversion cases. Mortality was zero. Six patients had a major complication. There were no cases of respiratory complication or recurrent laryngeal nerve palsy. Three patients had a radiological fistula (21.4%), successfully treated by endoscopic stenting, and one (7.1%) had an anastomosis leak needing reoperation. There were two cases of chylothorax (14.3%).

Conclusions: Our initial results suggest that the reported technique is safe and satisfies the oncological principles. It provides the advantages of minimally invasive surgery by overcoming some limitations of conventional thoracoscopy.