Computer Aided Surgery for Minimally Invasive Therapy

Abstract

Minimally invasive therapy such as endoscopic surgery and catheter based intervention since less pain and complication due to intervention. However, surgeon’s skills required for minimally invasive therapies are complicated since the surgeons have to manipulate various medical devices in a narrow surgical field with vision. Thus engineering assistance is important to realize safe and effective minimally invasive therapy. As the second vision of surgeon, we can utilize three dimensional medical imaging systems such as X-ray CT, MRI, Ultrasound Imaging, and high quality endoscope. Three dimensional anatomical information and function functional information registered to three dimensional position of the patient can be used to navigate surgeon’s therapy with assistance of information processing by high performance computers. There is also demand for functional information that provides pathological information of patient tissue. These measurement devices should have function to determine their three-dimensional position relative to the patient in addition to their main measurement information when they are integrated in image-guidance system for surgery. In addition to conventional medical imaging devices, biomedical instrumentation device incorporating three dimensional position tracking system can be also used for image guided surgery. One example is 5-aminolevulinic and (5-ALA) induced fluorescence measurement for intra-operative detection of brain tumor. We have developed an optical pickup device mounted on a motor driven X-Y stage. The 5-ALA induced fluorescence detection system with a mechanical scanning system was integrated with a surgical navigation system. The fluorescence spectra were registered to the corresponding location in surgical navigation map. As the second hand of a surgeon, robotic/mechatronic devices can be used to position various therapeutic/diagnostic devices in living body even when it is difficult for surgeons to manipulate it manually. Surgeons can overcome limitation of manual procedures by introduction of robotic devices. Robotics devices can provide more precise positioning, remote-controlled manipulation of medical devices in small and deep space of patient body where surgeons’ hands cannot approach. This new field of technology is called as Computer Aides Surgery(CAS), Computer Assisted Intervention(CAI), or Computer Integrated Surgery(CIS). Combination of advanced medical instrumentation including three dimensional anatomical/functional imaging, robotic/mechatornic devices and advance information processing and computer control will realize more efficient, safer medical intervention with less invasiveness.