Estimation of Incision Patterns Based on Visual Tracking of Surgical Tools in Minimally Invasive Surgery

Author(s):  
Xiaochuan Sun ◽  
Shahram Payandeh

In minimally invasive surgery, the positions of surgical tools are important in multiple instruments set-up and procedures. Typically, each surgery requires 4–5 incision holes and for each specific procedure, the layout of points defines specific pattern. Taking advantage of this possible one-to-one relationship between a specific procedure in minimally invasive surgery and the incision patterns, such patterns can be utilized in tele-monitoring of trainee during an emulated surgical operation. For example, in performance evaluation of trainee, this procedure would automatically estimate and verify the initial incision pattern to that of the predefined expected template associated with a particular surgical procedure. In this paper, we propose and analyze two models, based on color and shape respectively, to reconstruct the pattern. Both approaches use image information only to reconstruct the incision patterns in three dimensional space. The challenge of monocular endoscopic view is the lack of depth perception which hindered the vision-based tracking of laparoscopic tools. To address the problem, we present a method to determine not only the spatial tip position of the surgical tools, but also their orientation with respect to the camera coordinate frame. Detailed formulation shows that how segmented tool edges and camera field of view localize the 3D orientations of tools. Then, 3D position of the tool tip is reconstructed using either color or edge detection method. Finally, the orientations and the position of tool tips uniquely determine the poses of the tools. From above procedures, geometrical models of cylindrical tools can be constructed in each sequence of mono-camera images. To further use the tracking result in order to localize the incision point, we computed the vectors of the cylindrical tool center lines at multiple poses at number of frames. Extracted incision point is further analyzed as a recognition pattern to map into the patients’ pre-operative incision procedure. Accuracy of 3D tool pose estimation and incision pattern is evaluated in real image sequences with known ground truth.

Author(s):  
Paul WJ Henselmans ◽  
Gerwin Smit ◽  
Paul Breedveld

One of the most prominent drivers in the development of surgical procedures is the will to reduce their invasiveness, attested by minimally invasive surgery being the gold standards in many surgical procedures and natural orifices transluminal endoscopic surgery gaining acceptance. A logical next step in this pursuit is the introduction of hyper-redundant instruments that can insert themselves along multi-curved paths referred to as Follow-the-Leader motion. In the current state of the art, two different types of Follow-the-Leader instruments can be distinguished. One type of instrument is robotized; the movements of the shaft are controlled from outside the patient by actuators, for example, electric motors, and a controller storing a virtual track of the desired path. The other type of instrument is more mechanical; the movements of the shaft are controlled from inside the patient by a physical track that guides the shaft along the desired path. While in the robotized approach all degrees of freedom of the shaft require an individual actuator, the mechanical approach makes the number of degrees of freedom independent from the number of actuators. A desirable feature as an increasing number of actuators will inevitably drive up costs and increase the footprint of an instrument. Building the physical track inside the body does, however, impede miniaturization of the shaft’s diameter. This article introduces a new fully mechanical approach for Follow-the-Leader motion using a pre-determined physical track that is placed outside the body. This new approach was validated with a prototype called MemoFlex, which supports a Ø5 mm shaft (standard size in minimally invasive surgery) that contains 28-degrees-of-freedom and utilizes a simple steel rod as its physical track. Even though the performance of the MemoFlex leaves room for improvement, especially when following multiple curves, it does validate the proposed concept for Follow-the-Leader motion in three-dimensional space.


2014 ◽  
Vol 5 ◽  
pp. MEI.S13342
Author(s):  
Francesca Destro ◽  
Noemi Cantone ◽  
Mario Lima

Minimally invasive surgery (MIS) is a relatively new surgery comprising various procedures performed with special miniaturized instruments and imaging reproduction systems. Technological advances have made MIS an efficient, safe, and applicable tool for pediatric surgeons with unquestionable advantages. The recent introduction of three-dimensional (3D) high definition systems has been advocated in order to overcome some of the problems related to standard MIS visual limitations. This short paper recapitulates the necessity to minimize MIS visualization limitations and reports the characteristics of new laparoscopic 3D systems.


Author(s):  
Kenoki Ohuchida ◽  
Makoto Hashizume

Recently, a robotic system was developed in the biomedical field to support minimally invasive surgery. The popularity of minimally invasive surgery has surged rapidly because of endoscopic procedures. In endoscopic surgery, surgical procedures are performed within a body cavity and visualized with laparoscopy or thoracoscopy. Since the initial laparoscopic cholecystectomy was performed in 1987, the implications for endoscopic procedures have continuously expanded, and endoscopic surgery is currently the standard for an increasing number of operations. Advances in laparoscopic surgery have led to less postoperative pain, shorter hospital stays, and an earlier return to work for many patients. However, performing laparoscopic procedures requires several skills that have never been required for conventional open surgery. The surgeon needs to coordinate his/her eyes and hands and acquire a skillful manner using long-shaft instruments as well as mentally interpret a two-dimensional environment as a three-dimensional one. Because learning such skills is stressful for most surgeons, performing a laparoscopic procedure is more physically and mentally demanding than performing an open procedure.


Author(s):  
J Kang ◽  
K Y Lee

Minimally invasive surgery has become mainstream in surgical management of colorectal disease. Based on evidence of oncologic safety and benefit to patients, laparoscopic colorectal surgery is regarded as a successful alternative to open surgery. Since the introduction of the da Vinci® system as another tool for minimally invasive surgery, there have been several reports regarding the feasibility and safety of the system. The authors looked at their experience with 412 robotic colorectal surgeries and found that it was feasible and safe. Incidence of operation-related morbidity was around 11 per cent and system-related problems were 2.4 per cent. There was no operation-related or system-related mortality. From a technological perspective, robotic surgery has several advantages over laparoscopic surgery, including a magnifying view with a three-dimensional image, a stable camera platform, and instruments with Endowrist® technology that allow for seven degrees of freedom of movement. However, there is still room for improvement. The revolution of robotic technology can aid in the realization of a dream: a smaller, cheaper, and more sophisticated robotic system, which will further facilitate the widespread application of robotic surgery to colorectal disease.


2014 ◽  
Vol 533 ◽  
pp. 60-63
Author(s):  
Yi Zhong Wang ◽  
Xiao Qiang Zhao ◽  
Yong Hong Wu ◽  
Ting Wei Niu ◽  
Qiao Jun Liu ◽  
...  

In minimally invasive surgery, needle is one of the most common devices that used to conduct different diagnosis and treatment tasks. In this paper, coordinates of articulated needle while being steered are studied. After analyzing bending directions, a simplified model of articulated needle is established. Accordingly, formulas for calculating the coordinates of important points in an articulated needle are got in both two dimensional and three dimensional spaces. By providing a theoretical basis for the steering of an articulated needle, its navigation accuracy can be improved.


2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Aimée Sakes ◽  
Awaz Ali ◽  
Jovana Janjic ◽  
Paul Breedveld

Even though technological advances have increased the application area of minimally invasive surgery (MIS), there are still hurdles to allow for widespread adoption for more complex procedures. The development of steerable instruments, in which the surgeon can alter the tip orientation, has increased the application area of MIS, but they are bulky, which limits their ability to navigate through narrow environments, and complex, which complicates miniaturization. Furthermore, they do not allow for navigating through complex anatomies. In an effort to improve the dexterity of the MIS instruments, while minimizing the outer dimensions, the previously developed cable-ring mechanism was redesigned, resulting in the thinnest, Ø 2 mm (Ø 1 mm lumen), eight degrees-of-freedom (DOF) multisteerable tip for MIS to date. The multisteerable tip consists of four steerable segments of 2DOF stackable elements allowing for ±90 deg articulation, as well the construction of complex shapes, actuated by 16 Ø 0.2 mm stainless steel cables. In a proof-of-principle experiment, an ultrasound transducer and optical shape sensing (OSS) fiber were inserted in the lumen, and the multisteerable tip was used to perform scanning motions in order to reconstruct a wire frame in three-dimensional (3D). This configuration could in future be used to safely navigate through delicate environments and allow for tissue characterization. Therefore, the multisteerable tip has the potential to increase the application area of MIS in future, as it allows for improved dexterity, the ability to guide several tip tools toward the operation area, and the ability to navigate through tight anatomies.


Author(s):  
Sinan Onal ◽  
Susana Lai-Yuen ◽  
Stuart Hart

Minimally invasive surgery (MIS) or laparoscopic surgery has changed the focus of surgery and has become an alternative to open surgical procedures. Operations are performed through small incisions in the abdomen thus avoiding the need for large incisions. This results in less tissue trauma, less scarring, and faster post-operative recovery time. However, the inherent challenges of laparoscopic procedures include limited visibility, constrained working space and the need for advanced surgical tools to safely and efficiently perform the surgical procedure. It is also necessary for surgeons to obtain advanced surgical training to perform these procedures.


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