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2.
Int J Surg Case Rep ; 68: 193-197, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32172195

RESUMEN

INTRODUCTION: The utility of intracystic administration of indocyanine green for near-infrared fluorescent cholangiography in acute calculous cholecystitis initially treated with percutaneous transhepatic gallbladder drainage (PTGBD) was described in this report. PRESENTATION OF CASE: Two cases who underwent near-infrared fluorescent cholangiography guided interval laparoscopic cholecystectomy two weeks post-PTGBD were studied retrospectively. Both patients were diagnosed with moderate acute calculous cholecystitis based on diagnostic criteria of the Tokyo guidelines. Two routes of indocyanine green administration were utilized during surgery, first through direct intracystic administration through PTGBD tube (5 ml of 12.5 mg ICG) to achieve critical view of safety and then intravenous administration (1 ml of 2.5 mg ICG) to visualize cystic artery. DISCUSSION: Both patients had critical view of safety visualized clearly with ICG with the operation time of 84 and 125 min in cases 1 and 2, respectively without any intra or postoperative complications. CONCLUSION: In comparison with intravenous ICG administration, trans-PTGBD ICG route can provide better signal-to-noise ratio by avoiding hepatic fluorescence and thus increasing the bile duct to liver contrast. However, ICG may enter the lymphatic system through necrotic and inflammatory gallbladder mucosa, of which lymph spillage during gallbladder dissection can obscure the fluorescent view.

3.
J Healthc Eng ; 2018: 3654210, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30631411

RESUMEN

Minimally invasive surgery (MIS) minimizes the surgical incisions that need to be made and hence reduces the physical trauma involved during the surgical process. The ultimate goal is to reduce postoperative pain and blood loss as well as to limit the scarring area and hence accelerate recovery. It is therefore of great interest to both the surgeon and the patient. However, a major problem with MIS is that the field of vision of the surgeon is very narrow. We had previously developed and tested an MIS panoramic endoscope (MISPE) that provides the surgeon with a broader field of view. However, one issue with the MISPE was its low rate of video stitching. Therefore, in this paper, we propose using the region of interest in combination with the downsizing technique to improve the image-stitching performance of the MISPE. Experimental results confirm that, by using the proposed method, the image size can be increased by more than 160%, with the image resolution also improving. For instance, we could achieve performance improvements of 10× (CPU) and 23× (GPU) as compared to that of the original method.


Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Algoritmos , Animales , Endoscopía/métodos , Fantasmas de Imagen , Grabación en Video
4.
Comput Methods Programs Biomed ; 113(3): 862-8, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24444752

RESUMEN

Laparoscopic surgery is indispensable from the current surgical procedures. It uses an endoscope system of camera and light source, and surgical instruments which pass through the small incisions on the abdomen of the patients undergoing laparoscopic surgery. Conventional laparoscope (endoscope) systems produce 2D colored video images which do not provide surgeons an actual depth perception of the scene. In this work, the problem was formulated as synthesizing a stereo image of the monocular (conventional) laparoscope image by incorporating into them the depth information from a 3D CT model. Various algorithms of the computer vision including the algorithms for the feature detection, matching and tracking in the video frames, and for the reconstruction of 3D shape from shading in the 2D laparoscope image were combined for making the system. The current method was applied to the laparoscope video at the rate of up to 5 frames per second to visualize its stereo video. A correlation was investigated between the depth maps calculated with our method with those from the shape from shading algorithm. The correlation coefficients between the depth maps were within the range of 0.70-0.95 (P<0.05). A t-test was used for the statistical analysis.


Asunto(s)
Imagenología Tridimensional/estadística & datos numéricos , Laparoscopía/estadística & datos numéricos , Algoritmos , Biología Computacional , Percepción de Profundidad , Tomografía Computarizada Cuatridimensional/estadística & datos numéricos , Humanos , Interpretación de Imagen Asistida por Computador/métodos , Cirugía Asistida por Video/estadística & datos numéricos
5.
Comput Methods Programs Biomed ; 113(3): 869-81, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24461259

RESUMEN

This paper presents an advanced augmented reality system for spinal surgery assistance, and develops entry-point guidance prior to vertebroplasty spinal surgery. Based on image-based marker detection and tracking, the proposed camera-projector system superimposes pre-operative 3-D images onto patients. The patients' preoperative 3-D image model is registered by projecting it onto the patient such that the synthetic 3-D model merges with the real patient image, enabling the surgeon to see through the patients' anatomy. The proposed method is much simpler than heavy and computationally challenging navigation systems, and also reduces radiation exposure. The system is experimentally tested on a preoperative 3D model, dummy patient model and animal cadaver model. The feasibility and accuracy of the proposed system is verified on three patients undergoing spinal surgery in the operating theater. The results of these clinical trials are extremely promising, with surgeons reporting favorably on the reduced time of finding a suitable entry point and reduced radiation dose to patients.


Asunto(s)
Sistemas de Computación , Enfermedades de la Columna Vertebral/cirugía , Cirugía Asistida por Computador/estadística & datos numéricos , Animales , Biología Computacional , Humanos , Imagenología Tridimensional/estadística & datos numéricos , Modelos Anatómicos , Modelos Animales , Fantasmas de Imagen , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Sus scrofa , Tomografía Computarizada por Rayos X , Vertebroplastia/métodos , Vertebroplastia/estadística & datos numéricos , Proyectos Humanos Visibles
6.
IEEE Trans Biomed Eng ; 60(9): 2603-13, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23674408

RESUMEN

Operation in minimally invasive surgery is more difficult since the surgeons perform operations without haptic feedback or depth perception. Moreover, the field of view perceived by the surgeons through endoscopy is usually quite limited. The goal of this paper is to allow surgeons to see wide-angle images from endoscopy without the drawback of lens distortion. The proposed distortion correction process consists of lens calibration and real-time image warping. The calibration step is to estimate the parameters in the lens distortion model. We propose a fully automatic Hough-entropy-based calibration algorithm, which provides calibration results comparable to the previous manual calibration method. To achieve real-time correction, we use graphics processing unit to warp the image in parallel. In addition, surgeons may adjust the focal length of a lens during the operation. Real-time distortion correction of a zoomable lens is impossible by using traditional calibration methods because the tedious calibration process has to repeat again if focal length is changed. We derive a formula to describe the relationship between the distortion parameter, focal length, and image boundary. Hence, we can estimate the focal length for a zoomable lens from endoscopic images online and achieve real-time lens distortion correction.


Asunto(s)
Algoritmos , Endoscopía/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Cirugía Asistida por Computador/métodos , Calibración , Simulación por Computador , Bases de Datos Factuales , Humanos
7.
Surg Endosc ; 26(12): 3655-62, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22736284

RESUMEN

BACKGROUND: Surgical procedures have undergone considerable advancement during the last few decades. More recently, the availability of some imaging methods intraoperatively has added a new dimension to minimally invasive techniques. Augmented reality in surgery has been a topic of intense interest and research. METHODS: Augmented reality involves usage of computer vision algorithms on video from endoscopic cameras or cameras mounted in the operating room to provide the surgeon additional information that he or she otherwise would have to recognize intuitively. One of the techniques combines a virtual preoperative model of the patient with the endoscope camera using natural or artificial landmarks to provide an augmented reality view in the operating room. The authors' approach is to provide this with the least number of changes to the operating room. Software architecture is presented to provide interactive adjustment in the registration of a three-dimensional (3D) model and endoscope video. RESULTS: Augmented reality including adrenalectomy, ureteropelvic junction obstruction, and retrocaval ureter and pancreas was used to perform 12 surgeries. The general feedback from the surgeons has been very positive not only in terms of deciding the positions for inserting points but also in knowing the least change in anatomy. CONCLUSIONS: The approach involves providing a deformable 3D model architecture and its application to the operating room. A 3D model with a deformable structure is needed to show the shape change of soft tissue during the surgery. The software architecture to provide interactive adjustment in registration of the 3D model and endoscope video with adjustability of every 3D model is presented.


Asunto(s)
Simulación por Computador , Imagenología Tridimensional , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Cirugía Asistida por Computador , Humanos , Programas Informáticos
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