Enhancing surgeons' gaze strategies in endoscopic surgery during simulated surgical emergency situations thanks to computer vision.

Deficient visualization in minimally invasive surgery often causes misperceptions, which can lead to an increase of iatrogenic lesions and complications. This is especially critical for novice surgeons, who are prone to adopt inadequate switching gaze strategies, thereby increasing the chance of unforeseen complications. In this paper the use of an additional computer-aided vision system was tested for improvement of the reaction of the surgeons to unforeseen complications. Gaze patterns were analyzed using a gaze tracker, as well as other metrics such as task completion time or reaction time to sudden bleeding. While completion time did not show significant difference between tested modalities (p<0.1), the reaction time showed a downward trend as more auxiliary computer-aided vision systems were added (p<0.005). These results support the benefits of including additional vision systems for minimally invasive surgery processes.Clinical Relevance- This work assesses the advantages of including an additional computer vision system to prevent unforeseen complications during minimally invasive surgeries.

Augmented Reality Holographic Visualization System for Surgery Auxiliary Visualization: Proof of Concept for Surgical Training.

An Augmented Reality (AR) system based on the holographic projection of the relevant anatomic structures is proposed for auxiliary visualization during surgeries. The current two-dimensional visualization systems require the surgeons to mentally extract the associated three-dimensional information during the interventions, which entails risks and complications. This work shows an AR holographic projection system for real-time three-dimensional representation of the relevant surgical information, thus overcoming this problem. As an initial proof of concept, the system is experimentally assessed as potential surgery training tool.Clinical Relevance- This work explores the potential of AR holographic projection systems for intraoperative assistance to the surgical team, starting from its possible use as surgery training and planning tool.

Non-Invasive Microwave-Based Imaging System for Early Detection of Breast Tumours.

This work introduces a microwave-based system able to detect tumours in breast phantoms in a non-invasive way. The data acquisition system is composed of a hardware system which involves high-frequency components (antennas, switches and cables), a microcontroller, a vector network analyser used as measurement instrument and a computer devoted to the control and automation of the operation of the system. Concerning the software system, the computer runs a Python script which is in charge of mastering and automatising all the required stages for the data acquisition, from initialisation of the hardware system to performing and saving the measurements. We also report on the design of the high-performance broadband antenna used to carry out the measurements, as well as on the algorithm employed to build the final medical images, based on an adapted version of the so-called Improved Delay-and-Sum (IDAS) algorithm improved by a Hamming window filter and averaging preprocessing. The calibration and start-up of the system are also described. The experimental validation includes the use of different tumour models with different dielectric properties inside the breast phantom. The results show promising tumour detection capabilities, even when there is low dielectric contrast between the tumoural and healthy tissues, as is the usual case for dense breasts in young women.

Validation of an RF Image System for Real-Time Tracking Neurosurgical Tools.

A radio frequency (RF)-based system for surgical navigation is presented. Surgical navigation technologies are widely used nowadays for aiding the surgical team with many interventions. However, the currently available options still pose considerable limitations, such as line-of-sight occlusion prevention or restricted materials and equipment allowance. In this work, we suggest a different approach based on a microwave broadband antenna system. We combine techniques from microwave medical imaging, which can overcome the current limitations in surgical navigation technologies, and we propose methods to develop RF-based systems for real-time tracking neurosurgical tools. The design of the RF system to perform the measurements is shown and discussed, and two methods (Multiply and Sum and Delay Multiply and Sum) for building the medical images are analyzed. From these measurements, a surgical tool's position tracking system is developed and experimentally assessed in an emulated surgical scenario. The reported results are coherent with other approaches found in the literature, while overcoming their main practical limitations. The discussion of the results discloses some hints on the validity of the system, the optimal configurations depending on the requirements, and the possibilities for future enhancements.

Glucose Concentration Measurement in Human Blood Plasma Solutions with Microwave Sensors.

Three microwave sensors are used to track the glucose level of different human blood plasma solutions. In this paper, the sensors are evaluated as glucose trackers in a context close to real human blood. Different plasma solutions sets were prepared from a human blood sample at several added glucose concentrations up to 10 wt%, adding also ascorbic acid and lactic acid at different concentrations. The experimental results for the different sensors/solutions combinations are presented in this work. The sensors show good performance and linearity as glucose level retrievers, although the sensitivities change as the rest of components vary. Different sensor behaviors depending upon the concentrations of glucose and other components are identified and characterized. The results obtained in terms of sensitivity are coherent with previous works, highlighting the contribution of glucose to the dielectric losses of the solution. The results are also consistent with the frequency evolution of the electromagnetic signature of glucose found in the literature, and are helpful for selecting frequency bands for sensing purposes and envisioning future approaches to the challenging measurement in real biological contexts. Discussion of the implications of the results and guidelines for further research and development of more accurate sensors is offered.

Portable Device Based on Microwave Resonator for Noninvasive Blood Glucose Monitoring.

A portable device for noninvasive blood glucose monitoring is presented. The device is based on a microwave open-loop microstrip resonator, acting as glucose sensor, following the results of a previous study. This work shows the design and development of the driving electronics, signal generation system, data processing, measurement setup and graphical user interface, to integrate the resonator into a device suitable for further experimentation in clinical scenarios. The measurement principle relies in the idea of relating the unloaded Q factor to the user's blood glucose level. An initial assessment is shown, whose results highlight some successful cases of blood glucose level tracking, and indicate the need for further research in clinical scenarios.

A Comparative Analysis of 2D and 3D Tasks for Virtual Reality Therapies Based on Robotic-Assisted Neurorehabilitation for Post-stroke Patients.

Post-stroke neurorehabilitation based on virtual therapies are performed completing repetitive exercises shown in visual electronic devices, whose content represents imaginary or daily life tasks. Currently, there are two ways of visualization of these task. 3D virtual environments are used to get a three dimensional space that represents the real world with a high level of detail, whose realism is determinated by the resolucion and fidelity of the objects of the task. Furthermore, 2D virtual environments are used to represent the tasks with a low degree of realism using techniques of bidimensional graphics. However, the type of visualization can influence the quality of perception of the task, affecting the patient's sensorimotor performance. The purpose of this paper was to evaluate if there were differences in patterns of kinematic movements when post-stroke patients performed a reach task viewing a virtual therapeutic game with two different type of visualization of virtual environment: 2D and 3D. Nine post-stroke patients have participated in the study receiving a virtual therapy assisted by PUPArm rehabilitation robot. Horizontal movements of the upper limb were performed to complete the aim of the tasks, which consist in reaching peripheral or perspective targets depending on the virtual environment shown. Various parameter types such as the maximum speed, reaction time, path length, or initial movement are analyzed from the data acquired objectively by the robotic device to evaluate the influence of the task visualization. At the end of the study, a usability survey was provided to each patient to analysis his/her satisfaction level. For all patients, the movement trajectories were enhanced when they completed the therapy. This fact suggests that patient's motor recovery was increased. Despite of the similarity in majority of the kinematic parameters, differences in reaction time and path length were higher using the 3D task. Regarding the success rates were very similar. In conclusion, the using of 2D environments in virtual therapy may be a more appropriate and comfortable way to perform tasks for upper limb rehabilitation of post-stroke patients, in terms of accuracy in order to effectuate optimal kinematic trajectories.

Design of a wearable bio-patch for monitoring patient's temperature.

New communication technologies allow us developing useful and more practical medical applications, in particular for ambulatory monitoring. NFC communication has the advantages of low powering and low influence range area, what makes this technology suitable for health applications. This work presents an explanation of the design process of planar NFC antennas in a wearable biopatch. The problem of optimizing the communication distance is addressed. Design of a biopatch for continuous temperature monitoring and experimental results obtained wearing this biopatch during daily activities are presented.

Supervised and dynamic neuro-fuzzy systems to classify physiological responses in robot-assisted neurorehabilitation.

This paper presents the application of an Adaptive Resonance Theory (ART) based on neural networks combined with Fuzzy Logic systems to classify physiological reactions of subjects performing robot-assisted rehabilitation therapies. First, the theoretical background of a neuro-fuzzy classifier called S-dFasArt is presented. Then, the methodology and experimental protocols to perform a robot-assisted neurorehabilitation task are described. Our results show that the combination of the dynamic nature of S-dFasArt classifier with a supervisory module are very robust and suggest that this methodology could be very useful to take into account emotional states in robot-assisted environments and help to enhance and better understand human-robot interactions.