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[IEEE 2018 IEEE International Conference on Imaging Systems and Techniques (IST) - Krakow, Poland (2018.10.16-2018.10.18)] 2018 IEEE International Conference on Imaging Systems and Techniques (IST) - A novel method to explore intrarenal arterial tree using micro-CT
摘要： The minimally invasive approach for renal surgeries, among others, requires preoperative determination of intrarenal arteries. Their proper identification based on standard preoperative CT images is still not a fully solved problem. Therefore, we decided to resolve this issue by providing a tree topology model using post-mortem kidneys. The number of vessels that compose intrarenal tree is so large, that it cannot by analyzed manually without the aid of image processing techniques. So that, the vessels has to be first depicted using an imaging technique that enables to provide superior resolution in comparison to standard CT scan. In this paper, we present a research on various injection materials enabling to fill the vascular beds in order to scan them using micro-CT and further reconstruct as a 3D model. The evaluated materials were chosen so that they are widely available and affordable. We compare them in terms of their ability to absorb ionizing radiation and penetrate vascular beds (density, viscosity), homogeneity, solidification rate, resistance to solvents and durability. We also present the technique of injecting kidney arteries with the use of the selected material - two-part epoxy adhesive with 10% iodine. In contrast to standard corrosive endocast preparation, in our case there is no need to remove soft parenchymal tissue which takes about two weeks using corrosive materials such as strong acids and bases. The proposed filling material enables to enhance vascular tree to such extend that micro-CT scans of the whole kidneys can be performed. This enables instantaneous substance injection and imaging without permanently destroying the soft tissue material. This approach can be used in various scenarios in which a filling material with the ability to increase radiation absorption is required and there is a need to maintain the integrity of the structure. To the best of our knowledge, this is the first such attempt. The obtained vascular trees by the means of micro-CT confirm the validity of the presented approach.
关键词： cast,micro-CT,3D vascular tree,minimally invasive surgery,contrast agents,ability to absorb ionizing radiation,kidney surgery,injection materials,kidney
更新于2025-09-23 15:23:52
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Technical notes Integrated image navigation system using head-mounted display in “RoboSurgeon” endoscopic radical prostatectomy
摘要： The safety and efficacy of minimally invasive surgery relies on visual information. We aimed to develop an integrated image navigation system (RoboSurgeon System) that combines head-mounted displays (HMDs) with multiple image modalities, and assessed its feasibility in 5 prostate cancer patients who underwent gasless single-port endoscopic radical prostatectomy. A robotically manipulated transrectal ultrasound (TRUS) system was used. In all cases, preoperative magnetic resonance (MR) images and intraoperative real-time images of an endoscope, TRUS, and HMD-mounted camera were integrated and displayed synchronously on each HMD in a four-split screen mode during the entire process. The TRUS helped identify the boundary with the adjacent structures endoscopically in reference to MR images. There were no negative incidents in intraoperative or postoperative courses. Integrated image navigation using HMDs as individualized monitors is feasible in the natural ergonomic position and may be beneficial to identify correct dissection planes. The efficacy of the RoboSurgeon System deserves further evaluation.
关键词： image navigation,prostate cancer,head-mounted display,minimally invasive surgery,transrectal ultrasound,radical prostatectomy
更新于2025-09-23 15:22:29
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Equine Surgery || Lasers in Veterinary Surgery
摘要： Surgical lasers facilitate minimally invasive surgery, allow surgical access to otherwise inaccessible areas, and induce tissue interactions, which cannot be obtained with conventional surgical instrumentation. Surgical laser procedures can be performed on an outpatient basis and have eliminated procedures that previously required general anesthesia and hospitalization. Surgeons should be knowledgeable about which procedures can be accomplished with surgical lasers and which are better suited to conventional surgery. This chapter will provide information and guidelines on the use of surgical lasers in equine surgery.
关键词： equine surgery,minimally invasive surgery,carbon dioxide laser,Surgical lasers,neodymium:yttrium-aluminum-garnet laser,holmium:yttrium-aluminum-garnet laser,diode laser
更新于2025-09-23 15:21:01
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Outcomes of Two Treatments for Uncomplicated Pilonidal Sinus Disease: Karydakis Flap Procedure and Sinus Tract Ablation Procedure Using a 1,470a??nm Diode Laser Combined With Pit Excision
摘要： Background and Objectives: An ideal treatment for pilonidal disease should feature a low recurrence rate, minimal incision, and rapid return to daily activities. We compared the outcomes of the well‐defined Karydakis technique (KT) and a combination of pit excision (PE) and sinus tract ablation using 1,470‐nm diode laser. Study Design/Materials and Methods: In this study, from January 2016 to January 2018, patients diagnosed with uncomplicated early‐stage pilonidal sinus disease were enrolled and were treated randomly, using KT (n = 28) or a PE/laser ablation technique (PE + LAT; n = 30). Results: The mean operative times were 36.4 (25–45) minutes in the KT group and 15.1 (12–20) minutes in the PE + LAT group. Postoperative Visual Analog Scale pain scores were 4.4 in the KT group and 2.1 in the PE + LAT group. The time periods to return to normal daily activities were 2.6 (1–5) days in the PE + LAT group and 12.8 (10–20) days in the KT group. The mean Likert satisfaction scores were 3.8 in the KT group and 4.8 in the PE + LAT group. The groups did not differ in terms of recurrence. Conclusions: Compared with the KT, the PE + LAT was associated with a shorter operative time, a more rapid return to normal activities, less pain, and a higher level of subjective satisfaction. We found that the PE + LAT was better than the KT for patients with early‐stage disease.
关键词： pilonidal sinus,karydakis,minimally invasive surgery,1,470‐nm diode laser,laser ablation,pit picking
更新于2025-09-23 15:19:57
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Real 3D approach vs 2D camera with and without real-time near-infrared imaging with indocyanine green for detection of endometriosis: a case-control study
摘要： Introduction: The complete surgical removal of endometriosis lesions is not always feasible because some implants may be very small or hidden. The use of intra-operative near-infrared radiation (NIR) imaging after intravenous injection of indocyanine green (ICG) coupled with robotic technical advances, including tridimensional and high-resolution vision, might improve detection rates. Material and methods: This is a retrospective, multicenter case-control study (Canadian Task Force classification II-2) on medical records of women with endometriosis that submitted to surgery at the Catholic University of Rome (controls) and the University of Bologna (Cases) between January, 2016, and March, 2018. Surgical and post-surgical data from the procedures were collected. We compared the visual detection rate of endometriotic lesions using near-infrared radiation imaging after intravenous injection of indocyanine green (NIR-ICG) in Real 3D (Cases) with the 2D Camera approach (Controls) in symptomatic women with pelvic endometriosis. Results: Twenty cases were matched as closely as possible with 27 controls. The suspected lesions identified both with the WL and the NIR-ICG approach were 116 and 70 in the Controls (2D) and Cases (3D), respectively. Among them, 16 of 116 controls (13.8%) and 12 of 70 cases (17.1%) were identified using only NIR-ICG imaging and collected as occult lesions (p=0.536). The overall NIR-ICG lesion identification showed a positive predictive value of 97.8%, negative predictive value of 82.3%, sensitivity of 82.0%, and specificity of 97.9% for the Control group, and a positive predictive value of 100%, negative predictive value of 97.1%, sensitivity of 97.1%, and specificity of 100% for the Cases group, confirming that NIR-ICG imaging is a good diagnostic and screening test (p=0.643 and p=0.791, according to the Cohen kappa tests, respectively for the laparoscopic and robotic groups). Conclusions: The few differences observed did not seem to be clinically relevant, thus making the two procedures comparable in terms of the ability to visually detect endometriotic lesions. Further prospective trials are needed to confirm our results.
关键词： near-infrared radiation,endometriosis,endometriosis surgical treatment,indocyanine green,minimally invasive surgery
更新于2025-09-19 17:13:59
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Multiple Iterations of Magnetic Resonance-Guided Laser Interstitial Thermal Ablation of Brain Metastases: Single Surgeon's Experience and Review of the Literature
摘要： BACKGROUND: Prior treatment with magnetic resonance-guided, laser-induced thermal therapy (LITT) is widely assumed not to be a contraindication for further treatment of brain lesions, including further iterations of LITT. However, the safety and efficacy of repeat LITT treatments have never been formally investigated. OBJECTIVE: To evaluate treatment with multiple iterations of LITT. METHODS: All patients treated with LITT at least twice at our institution were included in the study. Outcomes and neurological examinations from before and after surgery were retrospectively examined from clinic notes. Perilesonal edema was determined at various timepoints using volumetric data derived from manual tracings of fluid-attenuated inversion recovery (FLAIR) enhancement on magnetic resonance imaging (MRI). Finally, a literature review of prior cases of repeat LITT was performed. RESULTS: A total of 9 patients underwent 18 treatments with LITT; all but 1 of whom were treated for metastatic brain lesions. One patient had a transient cerebrospinal fluid leak, whereas a second patient had a superficial wound infection, both of which resolved with standard medical care. The remaining 7 patients tolerated all LITT procedures without complication. Analysis of perilesional edema volume demonstrated a correlation with the amount of energy delivered during LITT. Literature review found 5 published papers describing 9 patients who underwent LITT more than once, the majority of whom tolerated repeat LITT well. CONCLUSION: LITT is a safe and promising treatment modality and may be used multiple times without issue. There appears to be an association between the amount of energy delivered during a LITT session and the degree of postoperative perilesional edema.
关键词： Brain tumor,Metastasis,Magnetic resonance laser-induced thermal therapy,Minimally invasive surgery,Tumor recurrence
更新于2025-09-12 10:27:22
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3D Laparoscopic Monitors
摘要： Minimally invasive surgery (MIS) is a relatively new surgery comprising various procedures performed with special miniaturized instruments and imaging reproduction systems. Technological advances have made MIS an efficient, safe, and applicable tool for pediatric surgeons with unquestionable advantages. The recent introduction of three-dimensional (3D) high definition systems has been advocated in order to overcome some of the problems related to standard MIS visual limitations. This short paper recapitulates the necessity to minimize MIS visualization limitations and reports the characteristics of new laparoscopic 3D systems.
关键词： three-dimensional surgery,minimally invasive surgery
更新于2025-09-10 09:29:36
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Moving-tolerant Augmented Reality Surgical Navigation System using Autostereoscopic 3D Image Overlay
摘要： Augmented reality (AR) surgical navigation systems based on image overlay have been used in minimally invasive surgery (MIS). However, conventional systems still suffer from a limited viewing zone, a shortage of intuitive three-dimensional (3D) image guidance and can’t be moved freely. To fuse the 3D overlay image with the patient in situ, it is essential to track the overlay device while it is moving. A direct line-of-sight should be maintained between the optical markers and the tracker camera. In this study, we propose a moving-tolerant AR surgical navigation system using autostereoscopic image overlay, which can avoid the use of the optical tracking system during the intraoperative period. The system captures binocular image sequences of environmental change in the operation room to locate the overlay device, rather than tracking the device directly. Therefore, it is no longer required to maintain a direct line-of-sight between the tracker and the tracked devices. The movable range of the system is also not limited by the scope of the tracker camera. Computer simulation experiments demonstrate the reliability of the proposed moving-tolerant AR surgical navigation system. We also fabricate a computer-generated integral photography (CGIP)-based 3D overlay AR system to validate the feasibility of the proposed moving-tolerant approach. Qualitative and quantitative experiments demonstrate that the proposed system can always fuse the 3D image with the patient, thus increasing the feasibility and reliability of traditional 3D overlay image AR surgical navigation systems.
关键词： integral photography,moving-tolerant,augmented reality,Minimally invasive surgery
更新于2025-09-09 09:28:46
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Endoscopic image enhancement with noise suppression
摘要： Stereoscopic endoscopes have been used increasingly in minimally invasive surgery to visualise the organ surface and manipulate various surgical tools. However, insuf?cient and irregular light sources become major challenges for endoscopic surgery. Not only do these conditions hinder image processing algorithms, sometimes surgical tools are barely visible when operating within low-light regions. In addition, low-light regions have low signal-to-noise ratio and metrication artefacts due to quantisation errors. As a result, present image enhancement methods usually suffer from heavy noise ampli?cation in low-light regions. In this Letter, the authors propose an effective method for endoscopic image enhancement by identifying different illumination regions and designing the enhancement design criteria for desired image quality. Compared with existing image enhancement methods, the proposed method is able to enhance the low-light region while preventing noise ampli?cation during image enhancement process. The proposed method is tested with 200 images acquired by endoscopic surgeries. Computed results show that the proposed algorithm can outperform state-of-the-art algorithms for image enhancement, in terms of naturalness image quality evaluator and illumination index.
关键词： image quality,endoscopic image enhancement,noise suppression,minimally invasive surgery,illumination regions
更新于2025-09-04 15:30:14