Computer-aided Surgical System Research Articles

Automatic registration method using EM sensors in the IoT operating room

The Internet of Things (IoT) in the operating room can aid to improve the quality of the computer-aided surgical system. Patient-to-image registration is an important issue for computer-aided surgical systems. Automating the procedure of patient-to-image registration could increase tracking accuracy and lower the time consumed for performing the procedure of registration. Therefore, we propose an automatic registration method to address this issue by constructing a wireless sensor network system for surgery. A plastic fiducial object combing with specific markers is developed to perform registration in that the ultimate purpose is to integrate them into a surgical robotic system for surgical navigation. The specific markers are designed to localize the position of the small EM sensor and can be automatically detected in CT/MRI images by an automatic algorithm. The positions of the EM tracking sensors can be calibrated during the procedure of registration. Some experiments are designed and performed, and the experimental results demonstrate that the proposed registration method is robust and accurate. The proposed registration method is a foundational link of the surgical robots combing with virtual or augmented reality technology that all these technologies will be performed in further surgical navigation.

Presence Detection of Surgical Tool Via Densely Connected Convolutional Networks

Surgical tool detection is important to surgical workflow recognition. It is considered as an essential task in surgical phase recognition. Recently, Densely Connected Convolutional Networks have gained a huge success in computer vision applications, especially in object detection and image Classification. In this paper, we proposed a method to solve the surgical tool presence detection problem as a multi-label classification problem based on Densely Connected Convolutional Networks. The performance of the proposed method has been evaluated in the surgical tool presence detection challenge dataset held by Modeling and Monitoring of Computer Assisted Interventions workshop. The result shows that our proposed model has achieved significant success in detecting surgical tool and got a mean average precision of 62.9% on the testing data. The technology studied in this paper has broad application prospects in computer-aided surgical systems and is a core component of the artificial intelligence medical operating room in the future.

Thermal effects of a combined irrigation method during implant site drilling. A standardized in vitro study using a bovine rib model

The purpose of this study was to evaluate the temperature changes during implant osteotomies with a combined irrigation system as compared to the commonly used external and internal irrigation under standardized conditions. Drilling procedures were performed on VII bovine ribs using a computer-aided surgical system that ensured automated intermittent drilling cycles to simulate clinical conditions. A total of 320 drilling osteotomies were performed with twist (2 mm) and conical implant drills (3.5/4.3/5 mm) at various drilling depths (10/16 mm) and with different saline irrigation (50 ml/min) methods (without/external/internal/combined). Temperature changes were recorded in real time by two custom-built thermoprobes with 14 temperature sensors (7 sensors/thermoprobe) at defined measuring depths. The highest temperature increase during osteotomies was observed without any coolant irrigation (median, 8.01°C), followed by commonly used external saline irrigation (median, 2.60°C), combined irrigation (median, 1.51°C) and ultimately with internal saline irrigation (median, 1.48°C). Temperature increase with different drill diameters showed significant differences (P < 0.05) regarding drill depth, confirming drill depth and time of drilling as influencing factors of heat generation. Internal saline irrigation showed a significantly smaller temperature increase (P < 0.05) compared with combined and external irrigation. A combined irrigation procedure appears to be preferable (P < 0.05) to an external irrigation method primarily with higher osteotomy depths. Combined irrigation provides sufficient reduction in temperature changes during drilling, and it may be more beneficial in deeper site osteotomies. Further studies to optimize the effects of a combined irrigation are needed.

First experience with a public domain computer-aided surgical system

The outcome of complex craniofacial operations is critically dependent on careful and accurate preoperative planning. Recent advances in computer technology enable the surgeon to do surgical simulations directly on to a computer terminal. We describe the clinical application of a public domain-based computer-aided system in craniofacial surgery. Operation planning was based on clinical investigations and radiological images, with particular use of a virtual three-dimensional surgical simulation. Three patients with complex craniofacial malformations were admitted for orbital correction. Surgical simulation defined numerically the extent of bone movements and the extent of resection areas. Operations were guided by the virtual planning. The outcome was compared with the planning to assess the accuracy of the operative correction. Our first experience confirms that computer-assisted simulation is a reliable and useful tool that improves surgical planning and helps to evaluate the surgical outcome.