computer aided surgery the emergence of medical cad cam l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Computer-Aided Surgery The emergence of medical CAD/CAM PowerPoint Presentation
Download Presentation
Computer-Aided Surgery The emergence of medical CAD/CAM

Loading in 2 Seconds...

play fullscreen
1 / 47

Computer-Aided Surgery The emergence of medical CAD/CAM - PowerPoint PPT Presentation


  • 250 Views
  • Uploaded on

Computer-Aided Surgery The emergence of medical CAD/CAM. Dr. Leo Joskowicz School of Computer Science and Engineering The Hebrew University of Jerusalem. Invited lecture, Tel-Aviv University, 23.3.2000. PAST: Cut, then see. PRESENT: See, then cut. Preoperative Imaging.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Computer-Aided Surgery The emergence of medical CAD/CAM' - Solomon


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
computer aided surgery the emergence of medical cad cam

Computer-AidedSurgeryThe emergence of medical CAD/CAM

Dr. LeoJoskowicz

School of Computer Science and Engineering

The Hebrew University of Jerusalem

Invited lecture, Tel-Aviv University, 23.3.2000

present see then cut
PRESENT: See, then cut

Preoperative Imaging

Intraoperative Execution

future combine see minimally cut
FUTURE: Combine, see, minimally cut

Image guidance

Augmented reality

computer aided surgery cas
Computer Aided Surgery (CAS)

Computer-based systems to enhance the surgeon’s dexterity, visual feedback, and information integration

  • Trend towards minimally invasive surgery:
    • laparoscopy, endoscopy, minimal incisions
  • Computer plays a key role in:
    • 3D visualization, model construction
    • quantitative integration of information
    • preoperative planning and intraoperative execution
  • Medical CAD/CAM -- a paradigm shift!
current practice
Current practice

CT

MRI + NMR

X-rays

Doppler US

computer based technologies

3D Visualization

Preoperative Planning

Intraoperative Navigation

Robotics

Computer-based technologies
talk outline
Talk outline
  • Elements of CAS systems
  • Three examples of CAS systems:

1. Navigation: FRACAS

2. Robotics: ROBODOC

3. Virtual colonoscopy and endoscopy

  • Conclusion, state of the art, and perspectives
medical cad cam a new paradigm r h taylor
Medical CAD/CAM: a new paradigm (R.H. Taylor)
  • CAD/CAM has revolutionized the way consumer goods are designed and produced.
  • The key: 3D visualization, simulation, design tools, precise CNC and robotic execution, and most importantly INTEGRATION
  • By analogy, apply paradigm to medicine: design is preoperative planning, production is intraoperative execution, postoperative evaluation is quality assurance
medical cad cam
Medical CAD/CAM
  • Differences: individualized data, custom planning and execution, safety
  • Medical CAD/CAM will change the ways in which are some conditions are diagnosed and treated
  • New computer-based technologies are more that “just another, fancier tool” because they provide unprecedented integration and potentially higher accuracy and repeatability
cas systems clinical specialties
CAS systems: clinical specialties
  • Neurosurgery:biopsies, tumor removal, epilepsy.
  • Orthopaedics:total hip and knee replacement trauma.
  • Laparoscopy and endoscopy: camera holders, simulators.
  • Craniofacial and maxillofacial surgery:fragment and cut planning, precise positioning
  • Emerging: radiology, dentristry, ophtalmology.
fracas cas for femur fracture reduction

FRACAS: CAS for femur fracture reduction

Joint project HUJI and Hadassah Hospital since 1996

Illustrates real-time navigation and integration in orthopaedics

fracas project goals
FRACAS: project goals
  • Substantial reduction of surgeon’s cumulative exposure to radiation
  • Reduction of alignement and positioning errors
  • Improve chances of completing the reduction closed
  • Improve the surgeon’s hand/eye coordination
  • Reduce overall intraoperative time and fatigue
  • Improved preoperative planning in both fracture assessment and nail selection
slide22
FRACAS conceptFollow the bone fragment positions with 3D models on a computer screen instead of fluoroscopy

CT+Fluoro-based

  • 3D bone fragment models from preop CT
  • Real-time bone fragment tracking
  • Registration with fluoroscopic images
fracas system concept

During surgery

CT images

computer

bone fragment

modelling

optical tracker

instruments

fluoroscopic

images

nail selection

patient

FRACAS system concept

Before surgery

fracas current status
FRACAS current status
  • Prototype system integrated with tracker
  • Fluoroscopic image processing completed: in-vitro tests show submilimetric accuracy
  • 2D/3D registration experiments in progress
  • In-vitro experimentation with bone holder
  • Key ideas: entire procedure support, fluoroscopy-based registration
robodoc thr
ROBODOC THR
  • Developed by Integrated Surgical Systems, IBM Research, Johns Hopkins (1986, 1994, 1997)
  • Precise implant positioning planning and machining of cementless hip implant canal
  • Reduces complications in canal preparation and implant fixation
  • Improves positioning and surface finish
  • Preoperative planning
  • Robotic intraoperative execution
total hip replacement procedure
Total hip replacement procedure

Procedure

Tools

Fluoroscopic images

robodoc total hip replacement
ROBODOC: Total Hip Replacement

F S

e e

m c

u t

r i

o

n

Manual broaching

Robotic broaching

robodoc thr current status
ROBODOC THR: current status
  • Over 4,000 surgeries in 20 centers since 1994
  • Very satisfactory short and mid-term results
  • Recent work on Revision THR
    • Interactive cement cut volume definition
    • Pin-based registration, work on fluoroscopic registration
endoscopy

video camera view

Endoscopy

anatomic structrure

virtual endoscopy
Virtual endoscopy
  • Purposes:
    • training simulator for surgeons
    • diagnosis of polypes and other tumors without actually inserting a video camera
  • Method: build a “fly-though” of the anatomy from CT and MRI data so that the surgeon can examine the anatomy or move the camera
  • Projects: Stony Brook, USA, Karlhuse, Germany
virtual endoscopy principle

Preprocessing

Interaction

Volume

acquisition

Segmentation

Navigation

Rendering

Input

Devices

Output

Devices

User

Virtual Endoscopy: principle
cas state of the art
CAS: state of the art
  • Neuronavigation: routine clinical use in a few dozen hospitals (including Israel)
  • Orthopaedics: about 7,000 pedicle screws, 4,000 robotic total hip replacements, a few hundred trauma cases
  • Laparoscopy, endoscopy: commercial arm
  • In Israel:IZMEL consortium on image-guided therapy
cas summary
CAS -- Summary
  • Medical CAD/CAM -- a new paradigm
  • Interdisciplinary:close cooperation in all stages of design and deployment!
  • Long term: long R&D cycle
  • Active and rapidly growing field; only the tip of the iceberg has been explored.
  • Extensive clinical studies are starting
  • Many challenging applied research problems
  • Commercial opportunities: established and start-up companies
grand challenges
Grand challenges
  • More percutaneous procedures
  • Soft tissue procedures: grafts, ligament releases, tendon transfer
  • Computational challenges:
    • deformable tissue shape and behavior modeling
    • image-based tracking (fluoroscopy, ultrasound)
    • accurate deformable registration
    • realistic surgical simulators
    • systems integration
slide46

ISRACAS’2000May 18, TechnionThird Israeli Symposium on Computer-Aided Surgery, Medical Robotics, and Medical Imaging

  • G. Barnett, USACAS Neurosurgery
  • J. Bowersocks, USA Telesurgery
  • P. Dario, Italy Medical Robotics
  • F. Jolesz, USA OR of the future
  • P. Merloz, France CAS Spine Surgery
  • 15 refereed papers + industrial exhibit session