DORC: Surgical Workflow Recognition Tool Using Fast R-CNN and Modified HMMs

2021 ◽  
pp. 636-644
Author(s):  
Pravalika Putalapattu
Keyword(s):  
Surgical Workflow

Cerebellopontine Angle Surgery Assisted by Continuous Mapping of the Facial Nerve Via the Ultrasonic Aspirator

2020 ◽  
Author(s):  
Marco Cenzato ◽  
Roberto Stefini ◽  
Francesco Zenga ◽  
Maurizio Piparo ◽  
Alberto Debernardi ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Facial Nerve ◽  
Cerebellopontine Angle ◽  
Continuous Mapping ◽  
Cost Effective ◽  
Current Intensity ◽  
Vestibular Schwannomas ◽  
Constant Current ◽  
Surgical Workflow ◽  
Ultrasonic Aspirator

Abstract Background Cerebellopontine angle (CPA) surgery carries the risk of lesioning the facial nerve. The goal of preserving the integrity of the facial nerve is usually pursued with intermittent electrical stimulation using a handheld probe that is alternated with the resection. We report our experience with continuous electrical stimulation delivered via the ultrasonic aspirator (UA) used for the resection of a series of vestibular schwannomas. Methods A total of 17 patients with vestibular schwannomas, operated on between 2010 and 2018, were included in this study. A constant-current stimulator was coupled to the UA used for the resection, delivering square-wave pulses throughout the resection. The muscle responses from upper and lower face muscles triggered by the electrical stimulation were displayed continuously on multichannel neurophysiologic equipment. The careful titration of the electrical stimulation delivered through the UA while tapering the current intensity with the progression of the resection was used as the main strategy. Results All operations were performed successfully, and facial nerve conduction was maintained in all patients except one, in whom a permanent lesion of the facial nerve followed a miscommunication to the neurosurgeon. Conclusion The coupling of the electrical stimulation to the UA provided the neurosurgeon with an efficient and cost-effective tool and allowed a safe resection. Positive responses were obtained from the facial muscles with low current intensity (lowest intensity: 0.1 mA). The availability of a resection tool paired with a stimulator allowed the surgeon to improve the surgical workflow because fewer interruptions were necessary to stimulate the facial nerve via a handheld probe.

scholarly journals 914 Impact of a standardized surgical workflow on outcomes of hysterectomy performed for morbidly adherent placenta

2021 ◽  
Vol 224 (2) ◽  
pp. S568
Author(s):  
Ali Wells ◽  
Matthew Anderson ◽  
Brittney Williams ◽  
Umit Kayisli ◽  
Judette Louis ◽  
...  
Keyword(s):  
Morbidly Adherent Placenta ◽  
Surgical Workflow ◽  
Adherent Placenta

scholarly journals Performance of a novel protease-activated fluorescent imaging system for intraoperative detection of residual breast cancer during breast conserving surgery

2021 ◽  
Vol 187 (1) ◽  
pp. 145-153
Author(s):  
Conor R. Lanahan ◽  
Bridget N. Kelly ◽  
Michele A. Gadd ◽  
Michelle C. Specht ◽  
Carson L. Brown ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Real Time ◽  
Imaging System ◽  
Ex Vivo ◽  
Menopausal Status ◽  
Fluorescent Imaging ◽  
Cancer Subtypes ◽  
Surgical Workflow ◽  
Tumor Types

Abstract Purpose Safe breast cancer lumpectomies require microscopically clear margins. Real-time margin assessment options are limited, and 20–40% of lumpectomies have positive margins requiring re-excision. The LUM Imaging System previously showed excellent sensitivity and specificity for tumor detection during lumpectomy surgery. We explored its impact on surgical workflow and performance across patient and tumor types. Methods We performed IRB-approved, prospective, non-randomized studies in breast cancer lumpectomy procedures. The LUM Imaging System uses LUM015, a protease-activated fluorescent imaging agent that identifies residual tumor in the surgical cavity walls. Fluorescent cavity images were collected in real-time and analyzed using system software. Results Cavity and specimen images were obtained in 55 patients injected with LUM015 at 0.5 or 1.0 mg/kg and in 5 patients who did not receive LUM015. All tumor types were distinguished from normal tissue, with mean tumor:normal (T:N) signal ratios of 3.81–5.69. T:N ratios were 4.45 in non-dense and 4.00 in dense breasts (p = 0.59) and 3.52 in premenopausal and 4.59 in postmenopausal women (p = 0.19). Histopathology and tumor receptor testing were not affected by LUM015. Falsely positive readings were more likely when tumor was present < 2 mm from the adjacent specimen margin. LUM015 signal was stable in vivo at least 6.5 h post injection, and ex vivo at least 4 h post excision. Conclusions Intraoperative use of the LUM Imaging System detected all breast cancer subtypes with robust performance independent of menopausal status and breast density. There was no significant impact on histopathology or receptor evaluation.

scholarly journals An Exploration of Augmented Reality in Computer Assisted Orthopaedic Surgery

10.29007/72d4 ◽  
2018 ◽  
Author(s):  
He Liu ◽  
Edouard Auvinet ◽  
Joshua Giles ◽  
Ferdinando Rodriguez Y Baena
Keyword(s):  
Augmented Reality ◽  
Three Dimensional ◽  
Hole Drilling ◽  
Depth Information ◽  
Computer Assisted ◽  
Pilot Hole ◽  
Surgical Workflow ◽  
Processing Depth ◽  
Computer Assisted Orthopaedic Surgery ◽  
Preoperative Plan

Computer Aided Surgery (CAS) is helpful, but it clutters an already overcrowded operating theatre, and tends to disrupt the workflow of conventional surgery. In order to provide seamless computer assistance with improved immersion and a more natural surgical workflow, we propose an augmented-reality based navigation system for CAS. Here, we choose to focus on the proximal femoral anatomy, which we register to a plan by processing depth information of the surgical site captured by a commercial depth camera. Intra-operative three-dimensional surgical guidance is then provided to the surgeon through a commercial augmented reality headset, to drill a pilot hole in the femoral head, so that the user can perform the operation without additional physical guides. The user can interact intuitively with the system by simple gestures and voice commands, resulting in a more natural workflow. To assess the surgical accuracy of the proposed setup, 30 experiments of pilot hole drilling were performed on femur phantoms. The position and the orientation of the drilled guide holes were measured and compared with the preoperative plan, and the mean errors were within 2mm and 2°, results which are in line with commercial computer assisted orthopedic systems today.

scholarly journals A New Approach in High Precision Bone Surgery: Semi-Automatic Alignment of an Application-Specific Instrument Guide Adjusted by a Smart Screwdriver

10.29007/bp2d ◽  
2018 ◽  
Author(s):  
Lukas Theisgen ◽  
Sabine Jeromin ◽  
Manuel Vossel ◽  
Sylvain Billet ◽  
Klaus Radermacher ◽  
...  
Keyword(s):  
Kinematic Chain ◽  
Lateral Direction ◽  
Human Errors ◽  
New Approach ◽  
Surgical Workflow ◽  
Bone Surgery ◽  
Handheld Device ◽  
Automatic Alignment ◽  
Cost Efficient ◽  
Application Specific

Robotic surgical systems reduce the cognitive workload of the surgeon by assisting in guidance and operational tasks. As a result, higher precision and a decreased surgery time are achieved, while human errors are minimised. However, most of robotic systems are expensive, bulky and limited to specific applications.In this paper a novel semi-automatic robotic system is evaluated that offers the high accuracies of robotic surgery while remaining small, universally applicable and easy to use. The system is composed of a universally applicable handheld device, called Smart Screwdriver (SSD) and an application specific kinematic chain serving as a tool guide. The guide mechanism is equipped with motion screws. By inserting the SSD into a screw head, the screw is identified automatically and the required number of revolutions is executed to achieve the desired pose of the tool guide.The usability of the system was evaluated according to IEC 60601-1-6 using pedicle screw implementation as an example. The achieved positioning accuracies of the drill sleeve were comparable to those of SpineAssist from Mazor Robotics Ltd., Caesarea (IL) with -0.54 ± 0.93 mm (max: 2.08 mm) in medial/lateral-direction and 0.17 ± 0.51 mm (max: 1.39 mm) in cranial/caudal-direction in the pedicle isthmus. Additionally, the system is cost-efficient, safe, easy to integrate in the surgical workflow and universally applicable to applications in which a static position in one or more DOF is to be adjusted.

Surgical workflow technique

ASVIDE ◽  
2017 ◽  
Vol 4 ◽  
pp. 265-265
Author(s):  
Ralph J. Mobbs ◽  
Andrew Lennox ◽  
Prashanth J. Rao ◽  
Kevin Phan ◽  
Wen Jie Choy
Keyword(s):  
Surgical Workflow

scholarly journals How Accurate Is Oral Implant Installation Using Surgical Guides Printed from a Degradable and Steam-Sterilized Biopolymer?

2020 ◽  
Vol 9 (8) ◽  
pp. 2322 ◽  
Author(s):  
Stefano Pieralli ◽  
Benedikt Christopher Spies ◽  
Valentin Hromadnik ◽  
Robert Nicic ◽  
Florian Beuer ◽  
...  
Keyword(s):  
Fused Deposition Modeling ◽  
Reference Group ◽  
Second Molar ◽  
Surgical Workflow ◽  
Surgical Guide ◽  
Fused Deposition ◽  
Implant Placement ◽  
Surgical Guides ◽  
Oral Implant ◽  
Observational Group

3D printed surgical guides are used for prosthetically-driven oral implant placement. When manufacturing these guides, information regarding suitable printing techniques and materials as well as the necessity for additional, non-printed stock parts such as metal sleeves is scarce. The aim of the investigation was to determine the accuracy of a surgical workflow for oral implant placement using guides manufactured by means of fused deposition modeling (FDM) from a biodegradable and sterilizable biopolymer filament. Furthermore, the potential benefit of metal sleeve inserts should be assessed. A surgical guide was designed for the installation of two implants in the region of the second premolar (SP) and second molar (SM) in a mandibular typodont model. For two additive manufacturing techniques (stereolithography [SLA]: reference group, FDM: observational group) n = 10 surgical guides, with (S) and without (NS) metal sleeves, were used. This resulted in 4 groups of 10 samples each (SLA-S/NS, FDM-S/NS). Target and real implant positions were superimposed and compared using a dedicated software. Sagittal, transversal, and vertical discrepancies at the level of the implant shoulder, apex and regarding the main axis were determined. MANOVA with posthoc Tukey tests were performed for statistical analyses. Placed implants showed sagittal and transversal discrepancies of <1 mm, vertical discrepancies of <0.6 mm, and axial deviations of ≤3°. In the vertical dimension, no differences between the four groups were measured (p ≤ 0.054). In the sagittal dimension, SLA groups showed decreased deviations in the implant shoulder region compared to FDM (p ≤ 0.033), whereas no differences in the transversal dimension between the groups were measured (p ≤ 0.054). The use of metal sleeves did not affect axial, vertical, and sagittal accuracy, but resulted in increased transversal deviations (p = 0.001). Regarding accuracy, biopolymer-based surgical guides manufactured by means of FDM present similar accuracy than SLA. Cytotoxicity tests are necessary to confirm their biocompatibility in the oral environment.

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