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1.
Sensors (Basel) ; 21(15)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34372398

RESUMO

Accurate semantic image segmentation from medical imaging can enable intelligent vision-based assistance in robot-assisted minimally invasive surgery. The human body and surgical procedures are highly dynamic. While machine-vision presents a promising approach, sufficiently large training image sets for robust performance are either costly or unavailable. This work examines three novel generative adversarial network (GAN) methods of providing usable synthetic tool images using only surgical background images and a few real tool images. The best of these three novel approaches generates realistic tool textures while preserving local background content by incorporating both a style preservation and a content loss component into the proposed multi-level loss function. The approach is quantitatively evaluated, and results suggest that the synthetically generated training tool images enhance UNet tool segmentation performance. More specifically, with a random set of 100 cadaver and live endoscopic images from the University of Washington Sinus Dataset, the UNet trained with synthetically generated images using the presented method resulted in 35.7% and 30.6% improvement over using purely real images in mean Dice coefficient and Intersection over Union scores, respectively. This study is promising towards the use of more widely available and routine screening endoscopy to preoperatively generate synthetic training tool images for intraoperative UNet tool segmentation.


Assuntos
Endoscopia , Processamento de Imagem Assistida por Computador , Humanos , Semântica
2.
Int J Comput Assist Radiol Surg ; 16(6): 933-941, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34009539

RESUMO

PURPOSE: Computational surgical planning tools could help develop novel skull base surgical approaches that improve safety and patient outcomes. This defines a need for automated skull base segmentation to improve the usability of surgical planning software. The objective of this work was to design and validate an algorithm for atlas-based automated segmentation of skull base structures in individual image sets for skull base surgical planning. METHODS: Advanced Normalization Tools software was used to construct a synthetic CT template from 6 subjects, and skull base structures were manually segmented to create a reference atlas. Landmark registration followed by Elastix deformable registration was applied to the template to register it to each of the 30 trusted reference image sets. Dice coefficient, average Hausdorff distance, and clinical usability scoring were used to compare the atlas segmentations to those of the trusted reference image sets. RESULTS: The mean for average Hausdorff distance for all structures was less than 2 mm (mean for 95th percentile Hausdorff distance was less than 5 mm). For structures greater than 2.5 mL in volume, the average Dice coefficient was 0.73 (range 0.59-0.82), and for structures less than 2.5 mL in volume the Dice coefficient was less than 0.7. The usability scoring survey was completed by three experts, and all structures met the criteria for acceptable effort except for the foramen spinosum, rotundum, and carotid artery, which required more than minor corrections. CONCLUSION: Currently available open-source algorithms, such as the Elastix deformable algorithm, can be used for automated atlas-based segmentation of skull base structures with acceptable clinical accuracy and minimal corrections with the use of the proposed atlas. The first publicly available CT template and anterior skull base segmentation atlas being released (available at this link: http://hdl.handle.net/1773/46259 ) with this paper will allow for general use of automated atlas-based segmentation of the skull base.


Assuntos
Algoritmos , Processamento de Imagem Assistida por Computador/métodos , Cuidados Pré-Operatórios/métodos , Base do Crânio/diagnóstico por imagem , Software , Adolescente , Adulto , Feminino , Humanos , Masculino , Procedimentos Neurocirúrgicos , Base do Crânio/cirurgia , Adulto Jovem
3.
World Neurosurg ; 142: 29-42, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32599213

RESUMO

In the present report, we have broadly outlined the potential advances in the field of skull base surgery, which might occur within the next 20 years based on the many areas of current research in biology and technology. Many of these advances will also be broadly applicable to other areas of neurosurgery. We have grounded our predictions for future developments in an exploration of what patients and surgeons most desire as outcomes for care. We next examined the recent developments in the field and outlined several promising areas of future improvement in skull base surgery, per se, as well as identifying the new hospital support systems needed to accommodate these changes. These include, but are not limited to, advances in imaging, Raman spectroscopy and microscopy, 3-dimensional printing and rapid prototyping, master-slave and semiautonomous robots, artificial intelligence applications in all areas of medicine, telemedicine, and green technologies in hospitals. In addition, we have reviewed the therapeutic approaches using nanotechnology, genetic engineering, antitumor antibodies, and stem cell technologies to repair damage caused by traumatic injuries, tumors, and iatrogenic injuries to the brain and cranial nerves. Additionally, we have discussed the training requirements for future skull base surgeons and stressed the need for adaptability and change. However, the essential requirements for skull base surgeons will remain unchanged, including knowledge, attention to detail, technical skill, innovation, judgment, and compassion. We believe that active involvement in these rapidly evolving technologies will enable us to shape some of the future of our discipline to address the needs of both patients and our profession.


Assuntos
Inteligência Artificial/tendências , Procedimentos Neurocirúrgicos/tendências , Procedimentos Ortopédicos/tendências , Impressão Tridimensional/tendências , Procedimentos Cirúrgicos Robóticos/tendências , Base do Crânio/cirurgia , Previsões , Engenharia Genética/métodos , Engenharia Genética/tendências , Humanos , Procedimentos Neurocirúrgicos/métodos , Procedimentos Ortopédicos/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Análise Espectral Raman/métodos , Transplante de Células-Tronco/métodos , Transplante de Células-Tronco/tendências
4.
IEEE Trans Industr Inform ; 15(4): 2054-2063, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31885525

RESUMO

Recently, Recurrent Neural Network (RNN) control schemes for redundant manipulators have been extensively studied. These control schemes demonstrate superior computational efficiency, control precision, and control robustness. However, they lack planning completeness. This paper explains why RNN control schemes suffer from the problem. Based on the analysis, this work presents a new random RNN control scheme, which 1) introduces randomness into RNN to address the planning completeness problem, 2) improves control precision with a new optimization target, 3) improves planning efficiency through learning from exploration. Theoretical analyses are used to prove the global stability, the planning completeness, and the computational complexity of the proposed method. Software simulation is provided to demonstrate the improved robustness against noise, the planning completeness and the improved planning efficiency of the proposed method over benchmark RNN control schemes. Real-world experiments are presented to demonstrate the application of the proposed method.

5.
JAMA Facial Plast Surg ; 21(3): 237-243, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30730533

RESUMO

Importance: There is no imaging standard to model nasal cartilage for the planning of rhinoplasty procedures. Preoperative visualization of cartilage may improve objective evaluation of nasal deformities, surgical planning, and surgical reconstruction. Objectives: To evaluate the feasibility of visualizing nasal cartilage using high resolution micro-computed tomography (CT) compared with the criterion standard of pathologic findings in a cadaveric specimen and to evaluate its accuracy compared with various clinical CT protocols. Design, Setting, and Participants: Anatomic study at the University of Washington using single human cadaveric nasal specimens performed from July 10, 2017, to March 30, 2018. Interventions: A micro-CT acquisition with 60-micron resolution was obtained of a nasal specimen. The specimen was then scanned with 5 different clinical CT protocols to span both clinical care and machine limits. The specimen was then sectioned in 5-mm axial slices for pathologic analysis. Main Outcomes and Measures: Micro-CT images were registered to pathologic specimen cross-sections using a graphite fiducial system. Cartilage substructures were manually segmented and analyzed. A library of matched images across the micro-CT and various clinical CT protocols was then developed. Region of interest analysis was performed for each of the cartilage structures and their boundaries on clinical CT protocols and micro-CT, with the outcome of mean (SD) density using Hounsfield units. Results: A single human cadaveric nasal specimen was used to obtain the following results. Lower lateral cartilage, upper lateral cartilage, and septal cartilage were accurately delineated on the micro-CT images compared with pathologic findings. The mean absolute deviation from pathologic findings was 0.30 mm for septal cartilage thickness, 0.98 mm for maximal upper lateral cartilage length, and 1.40 mm for maximal lower lateral cartilage length. On clinical CT protocols, only septal cartilage was well discriminated from boundary. Higher radiation dose resulted in more accurate density measurements of cartilage, but it did not ultimately improve ability to discriminate cartilage. Conclusions and Relevance: The results of this anatomic study may represent a notable step toward advancing knowledge of the capabilities and pitfalls of nasal cartilage visualization on CT. Nasal cartilage visualization was feasible on the micro-CT compared with pathologic findings. Future research may further examine the barriers to accurately visualizing upper lateral cartilage and lower lateral cartilage, a prerequisite for clinical application. Level of Evidence: NA.


Assuntos
Cartilagens Nasais/diagnóstico por imagem , Rinoplastia , Tomografia Computadorizada por Raios X/métodos , Microtomografia por Raio-X/métodos , Cadáver , Estudos de Viabilidade , Humanos , Cartilagens Nasais/patologia
6.
Surg Innov ; 25(5): 476-484, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29947581

RESUMO

Successful multidisciplinary treatment of skull base pathology requires precise preoperative planning. Current surgical approach (pathway) selection for these complex procedures depends on an individual surgeon's experiences and background training. Because of anatomical variation in both normal tissue and pathology (eg, tumor), a successful surgical pathway used on one patient is not necessarily the best approach on another patient. The question is how to define and obtain optimized patient-specific surgical approach pathways? In this article, we demonstrate that the surgeon's knowledge and decision making in preoperative planning can be modeled by a multiobjective cost function in a retrospective analysis of actual complex skull base cases. Two different approaches- weighted-sum approach and Pareto optimality-were used with a defined cost function to derive optimized surgical pathways based on preoperative computed tomography (CT) scans and manually designated pathology. With the first method, surgeon's preferences were input as a set of weights for each objective before the search. In the second approach, the surgeon's preferences were used to select a surgical pathway from the computed Pareto optimal set. Using preoperative CT and magnetic resonance imaging, the patient-specific surgical pathways derived by these methods were similar (85% agreement) to the actual approaches performed on patients. In one case where the actual surgical approach was different, revision surgery was required and was performed utilizing the computationally derived approach pathway.


Assuntos
Procedimentos Neurocirúrgicos/educação , Procedimentos Neurocirúrgicos/métodos , Base do Crânio/cirurgia , Simulação por Computador , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Semântica , Base do Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X
7.
Int J Med Robot ; 14(1)2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29105281

RESUMO

BACKGROUND: Complete brain tumour resection is an extremely critical factor for patients' survival rate and long-term quality of life. This paper introduces a prototype medical robotic system that aims to automatically detect and clean up brain tumour residues after the removal of tumour bulk through conventional surgery. METHODS: We focus on the development of an integrated surgical robotic system for image-guided robotic brain surgery. The Behavior Tree framework is explored to coordinate cross-platform medical subtasks. RESULTS: The integrated system was tested on a simulated laboratory platform. Results and performance indicate the feasibility of supervised semi-automation for residual brain tumour ablation in a simulated surgical cavity with sub-millimetre accuracy. The modularity in the control architecture allows straightforward integration of further medical devices. CONCLUSIONS: This work presents a semi-automated laboratory setup, simulating an intraoperative robotic neurosurgical procedure with real-time endoscopic image guidance and provides a foundation for the future transition from engineering approaches to clinical application.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Glioma/diagnóstico por imagem , Glioma/cirurgia , Procedimentos Cirúrgicos Robóticos , Técnicas Estereotáxicas , Cirurgia Assistida por Computador/métodos , Encéfalo , Desenho Assistido por Computador , Endoscopia , Desenho de Equipamento , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional , Procedimentos Neurocirúrgicos , Processamento de Sinais Assistido por Computador , Software
8.
J Neurol Surg B Skull Base ; 78(6): 490-496, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29134168

RESUMO

Background Most existing objective surgical motion analysis schemes are limited to structured surgical tasks or recognition of motion patterns for certain categories of surgeries. Analyzing instrument motion data with respect to anatomical structures can break the limit, and an anatomical region segmentation algorithm is required for the analysis. Methods An atlas was generated by manually segmenting the skull base into nine regions, including left/right anterior/posterior ethmoid sinuses, frontal sinus, left and right maxillary sinuses, nasal airway, and sphenoid sinus. These regions were selected based on anatomical and surgical significance in skull base and sinus surgery. Six features, including left and right eye center, nasofrontal beak, anterior tip of nasal spine, posterior edge of hard palate at midline, and clival body at foramen magnum, were used for alignment. The B-spline deformable registration was adapted to fine tune the registration, and bony boundaries were automatically extracted for final precision improvement. The resultant deformation field was applied to the atlas, and the motion data were clustered according to the deformed atlas. Results Eight maxillofacial computed tomography scans were used in experiments. One was manually segmented as the atlas. The others were segmented by the proposed method. Motion data were clustered into nine groups for every dataset and outliers were filtered. Conclusions The proposed algorithm improved the efficiency of motion data clustering and requires limited human interaction in the process. The anatomical region segmentations effectively filtered out the portion of motion data that are out of surgery sites and grouped them according to anatomical similarities.

9.
IEEE Robot Autom Lett ; 2(3): 1312-1319, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29130067

RESUMO

Haptic feedback is a critical but a clinically missing component in robotic Minimally Invasive Surgeries. This paper proposes a Gaussian Process Regression(GPR) based scheme to address the gripping force estimation problem for clinically commonly used elongated cable-driven surgical instruments. Based on the cable-driven mechanism property studies and surgical robotic system properties, four different Gaussian Process Regression filters were designed and analyzed, including: one GPR filter with 2-dimensional inputs, one GPR filter with 3-dimensional inputs, one GPR Unscented Kalman Filter (UKF) with 2-dimensional inputs, and one GPR UKF with 3-dimensional inputs. The four proposed methods were compared with the dynamic model based UKF filter on a 10mm gripper on the Raven-II surgical robot platform. The experimental results demonstrated that the four proposed methods outperformed the dynamic model based method on precision and reliability without parameter tuning. And surprisingly, among the four methods, the simplest GPR Filter with 2-dimensional inputs has the best performance.

10.
J Med Imaging (Bellingham) ; 4(3): 034501, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28744478

RESUMO

We present a fully automatic method for segmenting orbital structures (globes, optic nerves, and extraocular muscles) in CT images. Prior anatomical knowledge, such as shape, intensity, and spatial relationships of organs and landmarks, were utilized to define a volume of interest (VOI) that contains the desired structures. Then, VOI was used for fast localization and successful segmentation of each structure using predefined rules. Testing our method with 30 publicly available datasets, the average Dice similarity coefficient for right and left sides of [0.81, 0.79] eye globes, [0.72, 0.79] optic nerves, and [0.73, 0.76] extraocular muscles were achieved. The proposed method is accurate, efficient, does not require training data, and its intuitive pipeline allows the user to modify or extend to other structures.

11.
J Neurol Surg B Skull Base ; 78(3): 222-226, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28603682

RESUMO

Objectives Describe instrument motion during live endoscopic skull base surgery (ESBS) and evaluate kinematics within anatomic regions. Design Case series. Setting Tertiary academic center. Participants A single skull base surgeon performed six anterior skull base approaches to the pituitary. Main Outcomes and Measures Time-stamped instrument coordinates were recorded using an optical tracking system. Kinematics (i.e., mean cumulative instrument travel, velocity, acceleration, and angular velocity) was calculated by anatomic region including nasal vestibule, anterior and posterior ethmoid, sphenoid, and lateral opticocarotid recess (lOCR) regions. Results We observed mean (standard deviation, SD) velocities of 6.14 cm/s (1.55) in the nasal vestibule versus 1.65 cm/s (0.34) near the lOCR. Mean (SD) acceleration was 7,480 cm/s 2 (5790) in the vestibule versus 928 cm/s 2 (662) near the lOCR. Mean (SD) angular velocity was 17.2 degrees/s (8.31) in the vestibule and 5.37 degrees/s (1.09) near the lOCR. We observed a decreasing trend in the geometric mean velocity, acceleration, and angular velocity when approaching the pituitary ( p < 0.001). Conclusion Using a novel method for analyzing instrument motion during live ESBS, we observed a decreasing trend in kinematics with proximity to the pituitary. Additional characterization of surgical instrument motion is paramount for optimizing patient safety and training.

12.
Surg Innov ; 24(4): 405-410, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28412879

RESUMO

OBJECTIVE: To develop a method to measure intraoperative surgical instrument motion. This model will be applicable to the study of surgical instrument kinematics including surgical training, skill verification, and the development of surgical warning systems that detect aberrant instrument motion that may result in patient injury. DESIGN: We developed an algorithm to automate derivation of surgical instrument kinematics in an endoscopic endonasal skull base surgery model. Surgical instrument motion was recorded during a cadaveric endoscopic transnasal approach to the pituitary using a navigation system modified to record intraoperative time-stamped Euclidian coordinates and Euler angles. Microdebrider tip coordinates and angles were referenced to the cadaver's preoperative computed tomography scan allowing us to assess surgical instrument kinematics over time. A representative cadaveric endoscopic endonasal approach to the pituitary was performed to demonstrate feasibility of our algorithm for deriving surgical instrument kinematics. CONCLUSIONS: Technical feasibility of automatically measuring intraoperative surgical instrument motion and deriving kinematics measurements was demonstrated using standard navigation equipment.


Assuntos
Algoritmos , Endoscopia/métodos , Processamento de Imagem Assistida por Computador/métodos , Cavidade Nasal , Procedimentos Neurocirúrgicos/métodos , Base do Crânio , Humanos , Monitorização Intraoperatória , Movimento (Física) , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/cirurgia , Base do Crânio/diagnóstico por imagem , Base do Crânio/cirurgia , Cirurgia Assistida por Computador/métodos , Instrumentos Cirúrgicos
13.
Med Phys ; 44(5): 2020-2036, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28273355

RESUMO

PURPOSE: Automated delineation of structures and organs is a key step in medical imaging. However, due to the large number and diversity of structures and the large variety of segmentation algorithms, a consensus is lacking as to which automated segmentation method works best for certain applications. Segmentation challenges are a good approach for unbiased evaluation and comparison of segmentation algorithms. METHODS: In this work, we describe and present the results of the Head and Neck Auto-Segmentation Challenge 2015, a satellite event at the Medical Image Computing and Computer Assisted Interventions (MICCAI) 2015 conference. Six teams participated in a challenge to segment nine structures in the head and neck region of CT images: brainstem, mandible, chiasm, bilateral optic nerves, bilateral parotid glands, and bilateral submandibular glands. RESULTS: This paper presents the quantitative results of this challenge using multiple established error metrics and a well-defined ranking system. The strengths and weaknesses of the different auto-segmentation approaches are analyzed and discussed. CONCLUSIONS: The Head and Neck Auto-Segmentation Challenge 2015 was a good opportunity to assess the current state-of-the-art in segmentation of organs at risk for radiotherapy treatment. Participating teams had the possibility to compare their approaches to other methods under unbiased and standardized circumstances. The results demonstrate a clear tendency toward more general purpose and fewer structure-specific segmentation algorithms.


Assuntos
Algoritmos , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Cabeça , Humanos , Pescoço
14.
J Neurol Surg B Skull Base ; 78(1): 99-104, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28180051

RESUMO

Objectives The objective of this study was to evaluate region-specific surgical instrument kinematics among novice and experienced surgeons performing endoscopic endonasal skull base surgery. Design Cadaveric experimental study. Setting Tertiary academic center. Participants Two novice and two experienced surgeons performed eight endoscopic total ethmoidectomies and sphenoidotomies using an optically tracked microdebrider. Main Outcome Measures Time-stamped Euclidian coordinates were recorded. Cumulative instrument travel, mean linear velocity and acceleration, and mean angular velocities were calculated in the anterior ethmoid, posterior ethmoid, and sphenoid sinus regions. Results Mean cumulative instrument travel (standard deviation) was highest in the posterior ethmoid region for both novice and experienced surgeons (9,795 mm [1,664] vs. 3,833 mm [1,080]). There was a trend in mean linear and angular velocities, and acceleration with increasing magnitudes for experienced surgeons compared with novices. Among experienced surgeons, we observed a trend of decreasing yaw velocity during the approach to the surgical target. Conclusions We present a novel method of evaluating surgical instrument motion with respect to anatomical regions of the skull base during endoscopic endonasal skull base surgery. These data may be used in the development of surgical monitoring and training systems to optimize patient safety.

15.
OTO Open ; 1(4): 2473974X17738959, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30480197

RESUMO

Objective: To determine whether wrist motion measured by a smartphone application can be used as a performance metric for a simulated airway procedure requiring both wrist and finger dexterity. We hypothesized that this accelerometer application could detect differences between novices and experienced surgeons performing simulated cricothyrotomy. Setting: Academic medical center. Study Design: Prospective pilot cohort study. Methods: Voluntary surgeons and nonsurgeons were recruited. After viewing a training video, smartphones with accelerometer applications were attached to both wrists while subjects performed a cricothyrotomy on a validated task trainer. Procedure time and motion parameters, including average resultant acceleration (ARA), total resultant acceleration (TRA), and suprathreshold acceleration events (STAEs), were collected for dominant and nondominant hands. Subjects were stratified by prior experience. Blinded experts scored each performance using Objective Structured Assessment of Technical Skills (OSATS), and t tests were used to compare performance. Results: Thirty subjects were enrolled. Median age was 26 years, and 20 subjects were male. In the dominant hand, significant differences were seen between novice and experienced surgeons in TRA (P = .005) and procedure time (P = .006), while no significant differences were seen in STAEs (P = .42) and ARA (P = .33). In the nondominant hand, all variables were significantly different between the 2 groups: STAEs (P = .012), ARA (P = .007), TRA (P = .004), and procedure time (P = .006). Conclusions: Wrist motion measured by a low-cost smartphone application can distinguish between novice and experienced surgeons performing simulated airway surgery. This tool provides cost-effective and objective performance feedback.

16.
Artigo em Inglês | MEDLINE | ID: mdl-25408249

RESUMO

Minimizing tissue damage and maintaining grasp stability are essential considerations in surgical grasper design. Most past and current research analyzing graspers used for tissue manipulation in minimally invasive surgery is based on in vitro experiments. Most previous work assessed tissue injury and grasp security by visual inspection; only a few studies have quantified it. The goal of the present work is to develop a methodology with which to compute tissue damage magnitude and grasp quality that is appropriate for a wide range of grasper-tissue interaction. Using finite element analysis (FEA), four graspers with varying radii of curvature and four graspers with different tooth sizes were analyzed while squeezing and pulling liver tissue. All graspers were treated as surgical steel with linear elastic material properties. Nonlinear material properties of tissue used in the FEA as well as damage evaluation were derived from previously reported in vivo experiments. Computed peak stress, integrated stress, and tissue damage were compared. Applied displacement is vertical and then horizontal to the tissue surface to represent grasp and retraction. A close examination of the contact status of each node within the grasper-tissue interaction surface was carried out to investigate grasp stability. The results indicate less tissue damage with increasing radius of curvature. A smooth wave pattern reduced tissue damage at the cost of inducing higher percentage of slipping area. This methodology may be useful for researchers to develop and test various designs of graspers. Also it could improve surgical simulator performance by reflecting more realistic tissue material properties and predicting tissue damage for the student.


Assuntos
Análise de Elementos Finitos , Fígado/patologia , Instrumentos Cirúrgicos , Fricção , Humanos , Modelos Biológicos , Necrose , Dinâmica não Linear , Estresse Mecânico
17.
Rep U S ; 2015: 2639-2645, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26705501

RESUMO

This paper considers the semi-automated robotic surgical procedure for removing the brain tumor margins, where the manual operation is a tedious and time-consuming task for surgeons. We present robust path planning methods for robotic ablation of tumor residues in various shapes, which are represented in point-clouds instead of analytical geometry. Along with the path plans, corresponding metrics are also delivered to the surgeon for selecting the optimal candidate in the automated robotic ablation. The selected path plan is then executed and tested on RAVEN™ II surgical robot platform as part of the semi-automated robotic brain tumor ablation surgery in a simulated tissue phantom.

18.
IEEE Int Conf Robot Autom ; 2015: 3868-3875, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-26405563

RESUMO

Medical robots have been widely used to assist surgeons to carry out dexterous surgical tasks via various ways. Most of the tasks require surgeon's operation directly or indirectly. Certain level of autonomy in robotic surgery could not only free the surgeon from some tedious repetitive tasks, but also utilize the advantages of robot: high dexterity and accuracy. This paper presents a semi-autonomous neurosurgical procedure of brain tumor ablation using RAVEN Surgical Robot and stereo visual feedback. By integrating with the behavior tree framework, the whole surgical task is modeled flexibly and intelligently as nodes and leaves of a behavior tree. This paper provides three contributions mainly: (1) describing the brain tumor ablation as an ideal candidate for autonomous robotic surgery, (2) modeling and implementing the semi-autonomous surgical task using behavior tree framework, and (3) designing an experimental simulated ablation task for feasibility study and robot performance analysis.

19.
J Endourol ; 29(11): 1295-301, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26057232

RESUMO

BACKGROUND: A surgeon's skill in the operating room has been shown to correlate with a patient's clinical outcome. The prompt accurate assessment of surgical skill remains a challenge, in part, because expert faculty reviewers are often unavailable. By harnessing the power of large readily available crowds through the Internet, rapid, accurate, and low-cost assessments may be achieved. We hypothesized that assessments provided by crowd workers highly correlate with expert surgeons' assessments. MATERIALS AND METHODS: A group of 49 surgeons from two hospitals performed two dry-laboratory robotic surgical skill assessment tasks. The performance of these tasks was video recorded and posted online for evaluation using Amazon Mechanical Turk. The surgical tasks in each video were graded by (n=30) varying crowd workers and (n=3) experts using a modified global evaluative assessment of Robotic Skills (GEARS) grading tool, and the mean scores were compared using Cronbach's alpha statistic. RESULTS: GEARS evaluations from the crowd were obtained for each video and task and compared with the GEARS ratings from the expert surgeons. The crowd-based performance scores agreed with the performance assessments by experts with a Cronbach's alpha of 0.84 and 0.92 for the two tasks, respectively. CONCLUSION: The assessment of surgical skill by crowd workers resulted in a high degree of agreement with the scores provided by expert surgeons in the evaluation of basic robotic surgical dry-laboratory tasks. Crowd responses cost less and were much faster to acquire. This study provides evidence that crowds may provide an adjunctive method for rapidly providing feedback of skills to training and practicing surgeons.


Assuntos
Competência Clínica , Crowdsourcing , Internet , Procedimentos Cirúrgicos Robóticos/normas , Gravação em Vídeo , Adulto , Feminino , Cirurgia Geral/educação , Cirurgia Geral/normas , Ginecologia/educação , Ginecologia/normas , Humanos , Internato e Residência , Masculino , Pessoa de Meia-Idade , Obstetrícia/educação , Obstetrícia/normas , Reprodutibilidade dos Testes , Procedimentos Cirúrgicos Robóticos/educação , Urologia/educação , Urologia/normas
20.
J Surg Res ; 196(2): 302-6, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-25888499

RESUMO

BACKGROUND: Objective assessment of surgical skills is resource intensive and requires valuable time of expert surgeons. The goal of this study was to assess the ability of a large group of laypersons using a crowd-sourcing tool to grade a surgical procedure (cricothyrotomy) performed on a simulator. The grading included an assessment of the entire procedure by completing an objective assessment of technical skills survey. MATERIALS AND METHODS: Two groups of graders were recruited as follows: (1) Amazon Mechanical Turk users and (2) three expert surgeons from University of Washington Department of Otolaryngology. Graders were presented with a video of participants performing the procedure on the simulator and were asked to grade the video using the objective assessment of technical skills questions. Mechanical Turk users were paid $0.50 for each completed survey. It took 10 h to obtain all responses from 30 Mechanical Turk users for 26 training participants (26 videos/tasks), whereas it took 60 d for three expert surgeons to complete the same 26 tasks. RESULTS: The assessment of surgical performance by a group (n = 30) of laypersons matched the assessment by a group (n = 3) of expert surgeons with a good level of agreement determined by Cronbach alpha coefficient = 0.83. CONCLUSIONS: We found crowd sourcing was an efficient, accurate, and inexpensive method for skills assessment with a good level of agreement to experts' grading.


Assuntos
Competência Clínica/normas , Crowdsourcing , Procedimentos Cirúrgicos Operatórios/normas , Humanos , Procedimentos Cirúrgicos Operatórios/educação
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