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Click to edit Master subtitle style 10/01/1431 Information Technology in Surgery
Click to edit Master subtitle style
10/01/1431
Information Technology in Surgery
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COMPUTER-ASSISTED SURGERY
Computer-assisted surgical planning :
Computer assisted surgical planning
involves the use of virtual environment technology to provide surgeons with realistic accurate models on which to teach surgery and plan and practice operation
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With virtual reality (VR) technology , the computer can create an environment that seems real but is not ,, The models created by VR can look , sound , feel real and respond to pressure . A model such as this allows surgeons not only to plan surgeries but also to practice operation without touch the patient
For example : plastic surgeon can practice on model of a face and see the results of their works
For example :
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Minimally invasive surgery (MIS)
MIS is surgery "utilizing an endoscope" performs procedure through small incisions that involve minimum of damage to healthy tissue
Gall bladder disease has been treated with minimally invasive technique for many years
The benefits of using (MIS) : Less bleeding. Shorter recovery time.
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Computer-Assisted in Surgery and Robotics Computer-assisted surgery makes use of
robotics and computer generated images. Special hardware and software are being
developed to help in implementation of surgical procedure , for example robots equipped with artificial intelligence which programmed to hear ,see and respond to their environment and helping to perform certain operation
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Robots unlike humans, can hold endoscope and other instruments without becoming tired or shaky.
Robots are able to compare tissue density and decide whether tissue is normal or not .
Feedback mechanism allow the robot to determine the proper pressure and tension needed to manipulate a particular object
Currently , doctors are trying to give robots a delicate sense of touch .to restore their sense of touch to surgeons
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Disadvantages to robotic surgery :
Time , for example: robotic assisted heart surgery can take nearly twice the amount of time that typical heart surgery takes.
Cost, with these improvements in technology the systems will become more complicated and the costs will rise
Size , the robotic take large space in operating room
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ROPODOC, AESOP, ZUES, da Vinci, MINERVA, and Other Robotic Devices the earliest use of a robot in surgery was
in hip replacement operations.
-ROPODOC a computer-controlled , image-directed robot that performed its first hip replacement in 1992 .
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ROBODOC
The surgeon inserts 3 pins into patient's hip .
ROPODOC will use these guides for locating the point to start drilling
ROPODOC works with ORTHODOC , which using CT scans creates a 3D image of the hip
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ROBODOC
Advantages :1. improve implant size , selection , position ,
and accuracy .2. it forces surgeons to plan carefully .• Studies :German study found that an operation had
never had to stopped for safety reasons with ROPODOC.
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AESOP (Automated endoscopic system for potential positioning )
an assistant in endoscopic procedures.
It responds to voice commands such as “ AESOP move left” , “ AESOP stop”
any surgeon who uses AESOP trains the robot to recognize his or her voice .
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AESOP
unlike a human assistant , AESOP does not become tired or shaky .
it has been used in a wide variety of procedures including appendectomy,
spleenectomy, and relief of intestinal obstruction
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zeUs has three interactive robotic arms . One of
which holds the endoscope , while the other two manipulate the surgical instrument .
the endoscope is controlled by voice commands.
the computer controlled robotic arms scale down the surgeon's movements, filtering out any hand tremor.
ZEUS it will be able to perform heart bypass surgery endoscopically , mitral valve replacement, and laparoscopic and thoracic surgery .
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Da Vinci
similar to ZEUS . Its wrists can move 180 degrees ( a
greater range of motion than humans have) and follow the surgeon's hand motions .the surgeon's hand attached to controls
One advantage of da Vinci is that it mimics the surgeon's hand motions .
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Da Vinci
It should be noted that at least one person has died in a robot-aided surgery
In 2004 da Vinci has been used in over two thousand heart and chest surgeries .
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MINERVA is a robot developed to perform
stereotactic neurosurgical procedures and some brain tumors .
The stereotactic method involves fixing a metal frame , similar to a cage , on patient's head .
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MINERVA The doctor selects the target.
MINERVA makes the calculations , and responding to the doctor's commands , performs the procedure
Less invasive than robot-assisted stereotactic neurosurgery , is stereotactic radiosurgery or gamma knife surgery .
It has performed over one thousand tumor biopsies.
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Other robots have been developedusing :
ARTEMIS with KISMET HERMES an operating system that connect the
operating room hardware into a network that a surgeon can control with voice commands .
The surgeon can use HERMES to take and print pictures and access to patient's electronic record including images and other information .
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Other robotic devices: ACROBOT ( Active Constraint Robot ) PROBOT helps in prostate surgery . Problems : a major problem with surgical robots is
their size and cost. Surgical Robots currently cost around $1
million The portable robot would cost about
$250.000
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Augmented reality
Because much computer assisted surgery is image guided, software has been developed that enhances what has surgeon sees. That kind of surgery is called augmented reality
it makes use of computer
generated imagery to provide the surgeon with information that otherwise un available .
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the computer generated images may either be fused with the image on the monitor or projected directly onto the patient body during the operation allowing the doctor to virtually see inside the patient .
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image on a monitor is two dimensional . ahead mounted display that combines the computer generated images and the image of the patient allows the surgeon to see three dimensional field and see different views by simply turning her or his head instead of adjusting the endoscope .
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Uses:
Ultrasound, image guided breast biopsies . Brain Surgery
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anew four dimensional model of human body is called GAVEman
use to plan surgery and to educate the
patient
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Telepresence surgery (distant surgery )
the doctor looks at an image of the patient , not the actual patient . the instrument in the surgeon hands feel real, but in fact they only direct the robot at a distant site that is performing the surgery .
Socrates : It is basically mentoring system, allowing a
surgeon in one place to give expert advice in real time to distant surgeon.
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NASA extreme environment mission NEEMO))operation the major purpose of these project is to
enable astronauts to be operated on in space from earth using wireless technology and robotics
NEEMO 7 NEEMO9 NEEMO12
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The Operating Room of the Future
Images from all sources will be integrated and available to surgeons and other personnel.
The display on four screens shows integrated patient information in an easy to understand format, in one location.
All personnel including doctors are identified and tracked by (RFID)tags.
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Discussion and Future Directions
Computer-assisted surgery encompasses every thing. And it is an evolving field.
Computer- generated images help make surgery more precise.
MIS results in: 1) Smaller incisions. 2) Less trauma. 3) Less Pain. 4) Shorter recovery time. {Economic
benefits}
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Difficulties involved in using MIS:
1- The work space is small.2-less eye-hand coordination of surgeon.
(To solve this problem a glove-like device is being developed.
.
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LASER in Surgery
LASER stand for: Light Amplification by the Stimulated Emission of Radiation.
Uses in surgery:1. cut, vaporize tumors.2. Seal small blood vessels.• Laser beam can be narrowed to the size
of a few cells.• Each type of laser produce a different
wave length.
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LASIK: is eye surgery that uses lasers to correct vision by changing the shape of the cornea permanently.
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Nanotechnology It is an emerging field of medicine. It works with objects on the scale of atoms
and molecules.
Nanotechnology holds promise in regenerative medicine.
Nanometer One Billionth of a meter.
The nanofibers are the key to stimulating the body into regenerating lost or damaged cells. {EX- regenerated heart cells after heart attack}.
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Conclusion
Computer- assisted surgery can:A. Reduce unnecessary cutting.B. Make operations more precise, less
invasive.• MIS is more difficult to learn and requires
more training than traditional surgery. • The most experimental area of computer-
assisted surgery is telepresence or distance surgery.
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It needs :1. High- bandwidth channels.2. Networks must be 100% reliable.
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