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Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Gabor Fichtinger, Ph.D.Gabor Fichtinger, Ph.D.Associate Professor, School of Computing

Cross-appointment w/ Departments of Mechanical and Materials Engineering, Electrical and Computer Engineering,

and Surgerywww.cs.queensu.ca/~gabor

www.cs.queensu.ca/home/cisc881www.cs.queensu.ca/home/cisc330

www.cs.queensu.ca/home/comp230

Computer Integrated Surgery Computer Integrated Surgery –– IntroductionIntroduction

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

PredictionPrediction

The impact of aided interventional technology on medical care in the next 30 years will be as great as the impact of CAD/CAM systems and technology on industrial production over the past 30 years.

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Mission StatementMission Statement

Develop basic science, technology, and engineered systems working cooperatively with physicians to significantly change the way interventions and surgical procedures are planned, carried out, monitored, and assessed.

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

• Mental computation• Mental coupling of plan to action• Hand-eye coordination

Couple the Information to ActionCouple the Information to Action

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Impact of CISImpact of CIS• Procedures performed “better”• Availability increased

Qua

lity

of p

roce

dure

s

Availability of procedures

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Computer Integrated Surgery Systems

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Computer-assisted planning

Patient-specific Model

Update Model

Computer-Assisted

Execution

Update Plan

Computer-Assisted

Assessment

Preoperative Intraoperative

Atlas

Postoperative

Patient

Surgical

Assistants

Surgical Assistant Systems

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Surgical CAD/CAM Systems

Computer-assisted planning

Patient-specific Model

Update Model Update Plan

Computer-Assisted

Assessment

Preoperative Intraoperative

Atlas

PostoperativePatient

Surgical “CAD”

Surgical “TQM”

Surgical “CAM”

Computer-Assisted

ExecutionOrganizedOrganized

By ComputerBy Computer

Tight computer linkduring surgery

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Computer Integrated Surgery

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Fundamental research barriers

Modeling & Analysis• Segmentation• Reconstruction• Data fusion• Treatment planning

Physical Interfaces • Imaging• Tracking & sensing• Robotics• Augmented reality

Systems Integration• System design & architecture• Performance analysis• Clinical applications

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Imaging

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Segmentation

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Reconstruction

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Data fusion

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Treatment planning

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Robots – for prostate cancer implants

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Robots – for prostate cancer biopsy

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Robots – for total hip/knee replacement

TKR MOVIE

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Robot – for laparoscopic telesurgery

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Robot – Steady Hand microsurgery

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Augmented reality

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

System architecture

Robot GUI (Python)

Interplant

Open source

Commercial

Custom

Robot Class (C++)

Galil driver Other libs

Servo Loop

Windows PC

Galil Controller

CommandProcessor Safety Loop

Ethernet

downloaded

DLL (C++)socket

wxPython/ wxWidgets

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Clinical applications

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

How can we get there?

Strong and committed teams

– Surgeons– Engineers– Industry

Focus on systems that address important needs

Rapid iteration with measurable goals

Have fun!

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

The real bottom line: patient care

• Provide new capabilities that transcend human limitations in surgery

• Increase consistency and quality of surgical treatments

• Promote better outcomesand more cost-effectiveprocesses in surgical practice

Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

Thank you !

gabor@cs.jhu.edu