Surgery with computerized virtual reality for the automatic detection of tumors.

We present a novel and highly accurate system based on informatics engineering capable of automatic detection of tumors directly in the operating field. The system can identify the outlines of the tumor, determine whether it is malignant or not, detect lymphadenopathy and determine whether nodes are metastasized or not. The highly elaborate system, based on artificial vision, has been used in 30 gastric and 5 pancreatic neoplasms, among other tumor types. Images of the surgical field were recorded with a video camera connected to a computer, which was operated by the engineer. Questions asked by the surgeon during the procedure were processed immediately and sent to the virtual reality helmet worn by the surgeon, to the TV monitor in the operating room, or to both. The system is based on purely physical and mathematical processes that work reliably; in this sense it is free from errors and is self-consistent, operator errors or hardware failure excepted. In all cases tested here the system correctly identified the tumor as benign or malignant, revealed the extension of the tumor, and detected lymph node metastases. In every case these results were confirmed by histological examination.

[Recurrent perforation of of the sigmoid colon associated with Ehlers-Danlos syndrome type IV]. / Perforación iterativa de colon sigmoide asociada al síndrome de Ehlers-Danlos tipo IV.

Ehlers-Danlos syndrome type IV is a heritable disease of type III collagen metabolism. Most patients have a defect either in the synthesis or structure of type III procollagen, a finding consistent with the fact that these patients are prone to spontaneous rupture of the aorta and intestines, tissues rich in type III collagen. The diagnosis is suspected in a patient with a combination of clinical manifestations and family history, but it is confirmed only by culture of the patient's skin fibroblasts and the demonstration of a defect in type III collagen metabolism. We present a patient with Ehlers-Danlos type IV syndrome who developed a recurrent colon perforation, and discuss the surgical strategy to prevent recurrences.