New technologies are being developed that can largely eliminate the need for harmful x-ray radiation during minimally invasive procedures:
- Optical tracking of instruments is combined with pre-operative scans and augmented reality, to show the surgeon the position of his instruments with respect to internal physiology;
- Electromagnetic and acoustic sensors show the position of the tip of an instrument with respect to a pre-operative scan or directly in a live ultrasound image. Breakthrough innovations in photonics are enabling optical shape sensing techniques that can reconstruct the shape of a catheter over its entire length;
- MEMS ultrasound technology will enable segmented large area body conformal ultrasound transducers that are capable of imaging large parts of the body without the need for a sonographer, to guide surgeons in a multitude of minimally invasive interventions.
The move from open surgery to minimally invasive interventions has led to a drastic reduction in hospitalization and post-surgical complications. As such it is one of the most effective instruments to reduce the cost of healthcare. Not surprisingly, minimally invasive surgery is now being used in almost every branch of surgery, and as a result the number of minimally invasive interventions has grown explosively over the past two decades.
Moving from open to minimal invasive surgery, image guidance is needed. X-ray imaging was a first logical step, but apart from the fact that it requires bulky equipment that is often obstructing the surgeon, it poses a considerable health risk to the patient and especially to the surgeon, while it only provides a 2D representation of the 3D physiology and 3D shape of the devices.
Innovative radiation free 3D device guidance will allow for a natural and easy navigation in the body resulting in more precise and successful interventions while minimizing radiation concerns. It will further reduce the need for open surgery and is therefore a significant driver in the reduction of healthcare cost.
In moore4Medical two X-ray free image guidance platforms will be developed and integrated into minimally invasive surgery workflows. In particular, optical tracking technologies will be developed that are able to track instruments outside as well as inside the human body. Instrument tracking outside the body is based on the integration of video cameras in an X-ray system for Image Guided Therapy. Tracking inside the body uses optical shape sensing technology, integrated into guidewires and catheters. Two clinical applications will be considered: vascular diseases and spinal surgery.
The main objective of this WP is to develop X-ray free image guidance platforms and integrate them in minimally invasive surgery workflows. In particular, optical tracking technologies will be developed that are able to track instruments outside as well as inside the human body. Instrument tracking outside the body is based on the integration of video cameras in an X-ray system for Image Guided Therapy. Tracking inside the body uses optical shape sensing technology, integrated into guidewires and catheters. Two clinical applications will be considered: vascular diseases and spinal surgery.
Optical shape sensing (OSS) support during minimally invasive vascular interventions has proven to be a realistic alternative for X-ray for navigational tasks during actual clinical procedures. However, interventions go beyond navigation. To support the
positioning of therapy devices a major breakthrough in technology is needed as the optically shape sensed devices will have to be back loadable since in minimal invasive interventions the instruments are shifted over the guidewire. At the same time this will make the OSS platform accessible to catheters and instruments of other manufacturers.
Optical Device Tracking (ODT) technology will be developed and integrated in the Philips image guided therapy platform. Surgical instruments in the Ennovate platform will be developed or adapted with markers to allow for optical tracking. First target application will be spinal surgery, but the platform allows for extending it to other application areas and related surgical instruments.