Computational Surgery and Dual Training (eBook)

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2009 | 2010
XVI, 315 Seiten
Springer US (Verlag)
978-1-4419-1123-0 (ISBN)

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The future of surgery is intrinsically linked to the future of computational sciences: the medical act will be computer assisted at every single step, from planning to post-surgery recovery and through the surgical procedure itself. Looking back at the history of surgery, surgery practice has changed drama- cally with the extensive use of revolutionary techniques, such as medical imaging, laparoscopy, endoscopy, sensors and actuators, and robots. This trend is dependent on the use of computer processing, computational method, and virtualization. Computational surgery will not only improve the ef?ciency and quality of surgery, but will also give new access to very complex operations that require extreme precision and minimum intrusion. Such examples are today's inoperable cancer tumors that have invaded critical tissues or nervous centers. In order for this milestone to be reached quicker and more ef?ciently, surgeons will have to become very familiar with computing methods, such as image analysis, augmented re- ity, and/or robotics. It will be critical for surgeons to assimilate computers in their training, understand how computers work, understand the limitations/advantages of these computer tools, and be able to interpret computer imaging and simulations.
The future of surgery is intrinsically linked to the future of computational sciences: the medical act will be computer assisted at every single step, from planning to post-surgery recovery and through the surgical procedure itself. Looking back at the history of surgery, surgery practice has changed drama- cally with the extensive use of revolutionary techniques, such as medical imaging, laparoscopy, endoscopy, sensors and actuators, and robots. This trend is dependent on the use of computer processing, computational method, and virtualization. Computational surgery will not only improve the ef?ciency and quality of surgery, but will also give new access to very complex operations that require extreme precision and minimum intrusion. Such examples are today's inoperable cancer tumors that have invaded critical tissues or nervous centers. In order for this milestone to be reached quicker and more ef?ciently, surgeons will have to become very familiar with computing methods, such as image analysis, augmented re- ity, and/or robotics. It will be critical for surgeons to assimilate computers in their training, understand how computers work, understand the limitations/advantages of these computer tools, and be able to interpret computer imaging and simulations.

Computational Surgery and Dual Training 1
Contributors 11
Part I Computer Assisted Management of Disease and Surgery 15
Breast-Conserving Therapy for Breast Cancer: Targets for Investigation to Improve Results 16
Breast Cancer Biology 16
Surgical Management of Early Breast Cancer 17
Targets for Improvement in BCT Surgery 19
The Impact of Surgical Lumpectomy on Breast Contour 20
The Impact of Radiation Therapy on Breast Cosmesis 21
Prediction of Pathologically Negative Surgical Margins After Lumpectomy 22
Summary 23
References 23
Changing Paradigms in the Management of Peripheral Vascular Disease: The Need for Integration of Knowledge, Imaging, and Therapeutics 25
Clinical Problem 25
Anatomy 26
Pathophysiology and Classification of Disease 26
Pathology of Angioplasty and Stenting 27
Intravascular Stents 28
Diagnostic Imaging 29
Endoluminal Procedures 31
Outcomes 32
Pharmacotherapy After PTA 33
Adjuvant Stenting 34
Drug Eluting Stents 35
Covered Stents 35
Atherectomy 35
Laser Assisted Angioplasty 36
Brachytherapy 37
Cryotherapy 37
Cutting Balloon PTA 38
Complications of Intervention 39
Exercise vs. Angioplasty 40
Surgery vs. Angioplasty 41
Economics 41
Conclusion 42
References 43
Part II Image Processing and Diagnostics 54
Brain MRI Segmentation 55
References 82
Knowledge-Driven Recognition and Segmentation of Internal Brain Structures in 3D MRI 84
Introduction 84
Dealing with Imprecision Using Fuzzy Sets 85
Knowledge Representation 85
Fusion 88
Segmentation and Recognition 90
Global Approach 91
Sequential Approach 92
CSP Based Approach 94
Outlook 95
References 97
New Dimensions in Diagnostic Imaging of the Aorta 100
Conventional Imaging 100
Computed Tomography 100
Magnetic Resonance Imaging 101
Aortic Dissections 101
MRI of Aortic Dissections 103
Contrast-Enhanced Imaging 103
2D Phase Contrast Magnetic Resonance Imaging 103
Real-Time Magnetic Resonance Imaging 105
Computational Fluid Dynamics 105
Motion Analysis of Aortic Septum 106
References 108
Methodological Advances on Pulse Measurement through Functional Imaging 110
Appendix 127
References 129
Parallel Multispectral Image Segmentation for Computer Aided Thyroid Cytology 131
Introduction 131
Challenges for FNAC Diagnosis 132
Multispectral Imaging 133
Computer-Aided Analysis Needs for Thyroid FNAC 134
Methods 135
Spectral Imaging 135
Image Segmentation 136
Parallelization 138
Results 140
Conclusions 142
References 143
Part III Image Driven Intervention and Robotics 145
Computer-Assisted Digestive Surgery 146
Introduction 146
Virtual Reality for Preoperative Surgical Planning 147
Virtual Reality for Preoperative Surgical Simulation 152
Virtual Reality for Intra-operative Assistance: Augmented Reality 154
Conclusions 157
References 158
Design of a Robotized Flexible Endoscope for Natural Orifice Transluminal Endoscopic Surgery 161
Introduction 161
Problematics 162
Related Work and Systems 163
Use of an Overtube 163
Articulated or Passive Instruments 164
Discrete or Continuous DOFs 164
The Triangulation Problem 164
Manipulation and Robotization of the Systems 164
Presentation of our Endoscopic Prototype 165
The Mechanical System 165
Motorization 166
Master Control of the System 167
The Whole Setup 168
The Advantages of Robotization for NOTES 170
Modeling of the System 170
Model 170
Triangulation Analysis 172
Control and Telemanipulation 174
Conclusion 175
References 175
MRI-Guided Robot-Assisted Interventions: An Opportunity and a Challenge in Computational Surgery 177
The Case for MR-Guided Robot-Assisted Interventions 177
A Developmental Platform for MR-Guided Robotic Interventions 182
Image-Guided Stereotactic Control 187
Image-Guided Freehand Control 188
Future Perspectives 192
References 194
Image-Guided Interventions and Robotics 197
Robot-Assisted Procedures in Interventional Radiology 197
Interventional Radiology 197
Procedures 197
Imaging 198
Robotized Interventional Radiology 199
Why Robots for Interventional Radiology? 199
Technological Issues 201
Examples of Image-Guided Robotic Systems 203
CT-Bot: A Body-Mounted System for Interventional Radiology Under CT-Guidance 204
Positioning Module 205
Needle Insertion Module 206
Discussion 209
CT Robotics 209
MRI Robotics 210
References 210
Part IV Modeling, Simulation and Experimental Data 212
Emerging Mechanisms of Vein Graft Failure: The Dynamic Interaction of Hemodynamics and the Vascular Response to Injury 213
Limited Durability of Vein Bypass Grafts 213
Hemodynamics: Modulator of Vascular Adaptation 214
Mathematical Modeling of Shear-Mediated Vein Graft Adaptation 217
System Biology and Vascular Adaptation 218
References 221
Modeling and Role of Leukocytes in Inflammation 224
Introduction 224
Leukocytes and Inflammation 225
Leukocyte Rolling Mechanism 226
Leukocyte Rheological Models 227
Viscoelastic Solid Model 227
Cortical Shell-Liquid Core Model 228
Non-Newtonian Model 228
Compound Drop Model 229
Leukocyte Rolling Models 230
Bond Model 231
Rigid Sphere Model 231
Compound Drop Model 231
Deformable 3-Dimensional Model 232
Systems Biology Approach 233
Summary and Conclusion 233
References 234
Multi-modality Imaging for the Simulation of Cerebral Aneurysm Blood Flow Dynamics 236
Cerebral Aneurysms 236
Treatment of Cerebral Aneurysms 237
Aneurysm Imaging 238
Aneurysm Rupture 241
Aneurysm Hemodynamics 242
Patient-Specific Computational Fluid Dynamics 242
Application of CFD for the Study of Cerebral Aneurysms 244
Multi-modality Imaging and Modeling of Cerebral Aneurysms Hemodynamics 247
Outlook 248
References 248
A Computational Framework for Breast Surgery: Application to Breast Conserving Therapy 252
References 269
Part V Training 270
Simulators in Training 271
Introduction 271
Types of Inanimate Simulators 272
Procedural Simulation 273
Developing a Laparoscopic Surgery Simulator 275
Determining the Reliability and Validity of a Simulator 276
Using Simulation to Test Procedural Skill 281
Conclusion 282
References 282
A Computational Desk for Surgeons 284
References 310
Index 313

Erscheint lt. Verlag 16.12.2009
Zusatzinfo XVI, 315 p.
Verlagsort New York
Sprache englisch
Themenwelt Medizin / Pharmazie Medizinische Fachgebiete Chirurgie
Medizin / Pharmazie Physiotherapie / Ergotherapie Orthopädie
Technik Elektrotechnik / Energietechnik
Technik Medizintechnik
Schlagworte augmented reality • biomedical engineers • Cancer • computational surgery • computing methods • Diagnostics • extreme precision • Image Analysis • Image Processing • Imaging • inflammation • interventional procedures • minimum intrusion • Optimization • Robotics • Signal Processing • Simulator • Surgery • Surgical techniques • tissue • vascular surgery
ISBN-10 1-4419-1123-5 / 1441911235
ISBN-13 978-1-4419-1123-0 / 9781441911230
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