Information Technology in

Surgery
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COMPUTER-ASSISTED
SURGERY
•
Computer-assisted surgical planning :

•
Computer assisted surgical planning
involves the use of virtual environment
technology to provide surgeons with
realistic accurate models on which to
teach surgery and plan and practice
operation

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 For example
:
•
With virtual reality (VR) technology , the
computer can create an environment
that seems real but is not ,, The models
created by VR can look , sound , feel
real and respond to pressure . A model
such as this allows surgeons not only to
plan surgeries but also to practice
operation without touch the patient
•
For example : plastic surgeon can
practice on model of a face and see the
results of their works
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 Minimally invasive surgery
(MIS)
•
MIS is surgery "utilizing an endoscope"
performs procedure through small
incisions that involve minimum of damage
to healthy tissue
•
Gall bladder disease has been treated
with minimally invasive technique for many
years
•
The benefits of using (MIS) :
•
Less bleeding.
•
Shorter recovery time.
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Computer-Assisted in
Surgery and Robotics
•
Computer-assisted surgery makes use of
robotics and computer generated images.
•
Special hardware and software are being
developed to help in implementation of
surgical procedure , for example robots
equipped with artificial intelligence which
programmed to hear ,see and respond to
their environment and helping to perform
certain operation
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•
Robots unlike humans, can hold
endoscope and other instruments without
becoming tired or shaky.
•
Robots are able to compare tissue density
and decide whether tissue is normal or
not .
•
Feedback mechanism allow the robot to
determine the proper pressure and
tension needed to manipulate a particular
object
•
Currently
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Disadvantages to robotic
surgery :
•
Time , for example: robotic assisted heart
surgery can take nearly twice the amount
of time that typical heart surgery takes.
•
Cost, with these improvements in
technology the systems will become more
complicated and the costs will rise
•
Size , the robotic take large space in
operating room
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ROPODOC, AESOP, ZUES, da
Vinci, MINERVA, and Other
Robotic Devices
•
the earliest use of a robot in surgery was
in hip replacement operations.

•
-ROPODOC a computer-controlled ,
image-directed robot that performed its
first hip replacement in 1992 .

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 ROBODOC
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The surgeon inserts 3 pins into
patient's hip .
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ROPODOC will use these guides
for locating the point to start drilling
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ROPODOC works with
ORTHODOC , which using CT
scans creates a 3D image of the
hip

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 ROBODOC


Advantages :
1. improve implant size , selection , position ,

and accuracy .
2. it forces surgeons to plan carefully .

•
Studies :
German study found that an operation had
never had to stopped for safety reasons
with ROPODOC.
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AESOP (Automated
endoscopic system for potential
positioning )
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an assistant in endoscopic procedures.

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It responds to voice commands such as “
AESOP move left” , “ AESOP stop”

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any surgeon who uses AESOP trains the
robot to recognize his or her voice .
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 AESOP

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unlike a human assistant , AESOP does
not become tired or shaky .

•
it has been used in a wide variety of
procedures including appendectomy,
spleenectomy, and relief of intestinal
obstruction
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•
zeUs
has three interactive robotic arms . One of
which holds the endoscope , while the
other two manipulate the surgical
instrument .
•
the endoscope is controlled by voice
commands.
•
the computer controlled robotic arms scale
down the surgeon's movements, filtering
out any hand tremor.
•
ZEUS it will be able to perform heart
bypass surgery endoscopically , mitral
valve replacement, and laparoscopic and
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thoracic surgery .
Da Vinci
•
similar to ZEUS .
•
Its wrists can move 180 degrees ( a
greater range of motion than humans
have) and follow the surgeon's hand
motions .the surgeon's hand attached to
controls
•
One advantage of da Vinci is that it
mimics the surgeon's hand motions .
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 Da Vinci

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It should be noted that at least one person
has died in a robot-aided surgery
•
In 2004 da Vinci has been used in over
two thousand heart and chest surgeries .

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 MINERVA
•
is a robot developed to perform
stereotactic neurosurgical procedures and
some brain tumors .
•
The stereotactic method involves fixing a
metal frame , similar to a cage , on
patient's head .

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 MINERVA
•
The doctor selects the target.
MINERVA makes the calculations ,
and responding to the doctor's
commands , performs the
procedure
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Less invasive than robot-assisted
stereotactic neurosurgery , is
stereotactic radiosurgery or
gamma knife surgery .
•
It has performed over one
thousand tumor biopsies.
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Other robots have been
developed
using :
•
ARTEMIS with KISMET
•
HERMES
•
an operating system that connect the
operating room hardware into a network
that a surgeon can control with voice
commands .
•
The surgeon can use HERMES to take
and print pictures and access to patient's
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electronic record including images and
 Other robotic devices:
•
ACROBOT ( Active Constraint Robot )
•
PROBOT
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helps in prostate surgery .
•
Problems :
•
a major problem with surgical robots is
their size and cost.
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Surgical Robots currently cost around $1
million
•
The portable robot would cost about
$250.000
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Augmented reality
•
Because much computer assisted
surgery is image guided, software
has been developed that enhances
what has surgeon sees. That kind
of surgery is called augmented
reality

•
it makes use of computer
generated imagery to provide the
surgeon with information that
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otherwise un available .
•
the computer generated images may
either be fused with the image on the
monitor or projected directly onto the
patient body during the operation allowing
the doctor to virtually see inside the
patient .

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•
image on a monitor is two dimensional .
ahead mounted display that combines the
computer generated images and the
image of the patient allows the surgeon to
see three dimensional field and see
different views by simply turning her or his
head instead of adjusting the endoscope .

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Uses:
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Ultrasound,
•
image guided breast biopsies .
•
Brain Surgery

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•
anew four dimensional model of human
body is called GAVEman

•
use to plan surgery and to educate the
patient

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Telepresence surgery
(distant surgery )
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the doctor looks at an image of the patient
, not the actual patient . the instrument in
the surgeon hands feel real, but in fact
they only direct the robot at a distant site
that is performing the surgery .
•
Socrates :
It is basically mentoring system, allowing a
surgeon in one place to give expert
advice in real time to distant surgeon.
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 NASA extreme
environment mission
NEEMO))operation
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the major purpose of these project is to
enable astronauts to be operated on in
space from earth using wireless
technology and robotics

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NEEMO 7
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NEEMO9
•
NEEMO12
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 The Operating Room of
the Future
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Images from all sources will be integrated
and available to surgeons and other
personnel.

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The display on four screens shows
integrated patient information in an easy to
understand format, in one location.

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All personnel including doctors are
identified and tracked by (RFID)tags.
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 Discussion and Future
Directions
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Computer-assisted surgery encompasses
every thing. And it is an evolving field.
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Computer- generated images help make
surgery more precise.
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MIS results in:
•
1) Smaller incisions.
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2) Less trauma.
•
3) Less Pain.
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4) Shorter recovery time. {Economic
benefits}
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 .
•
Difficulties involved in using
MIS:

1- The work space is small.

2-less eye-hand coordination of surgeon.
(To solve this problem a glove-like device
is being developed.

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LASER in Surgery
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LASER stand for: Light
Amplification by the Stimulated
Emission of Radiation.
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Uses in surgery:
1. cut, vaporize tumors.
2. Seal small blood vessels.
•
Laser beam can be narrowed to the size
of a few cells.
•
Each type of laser produce a different
wave length.
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•
LASIK: is eye surgery that uses lasers to
correct vision by changing the shape of
the cornea permanently.

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Nanotechnology
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It is an emerging field of medicine.
•
It works with objects on the scale of atoms
and molecules.

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Nanotechnology holds promise in
regenerative medicine.

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Nanometer One Billionth of a meter.

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The nanofibers are the key to stimulating
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the body into regenerating lost or
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Conclusion
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Computer- assisted surgery can:
A. Reduce unnecessary cutting.
B. Make operations more precise, less
invasive.
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MIS is more difficult to learn and requires
more training than traditional surgery.
•
The most experimental area of computer-
assisted surgery is telepresence or
distance surgery.
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 •
It needs :
1. High- bandwidth channels.
2. Networks must be 100% reliable.

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