The use of Augmented Reality (AR) for navigation purposes has shown beneficial in assisting physicians during the performance of surgical procedures. These applications commonly require knowing the pose of surgical tools and patients to provide visual information that surgeons can use during the performance of the task. Existing medical-grade tracking systems use infrared cameras placed inside the Operating Room (OR) to identify retro-reflective markers attached to objects of interest and compute their pose. Some commercially available AR Head-Mounted Displays (HMDs) use similar cameras for self-localization, hand tracking, and estimating the objects' depth. This work presents a framework that uses the built-in cameras of AR HMDs to enable accurate tracking of retro-reflective markers without the need to integrate any additional electronics into the HMD. The proposed framework can simultaneously track multiple tools without having previous knowledge of their geometry and only requires establishing a local network between the headset and a workstation. Our results show that the tracking and detection of the markers can be achieved with an accuracy of 0.09 ± 0.06 mm on lateral translation, 0.42 ± 0.32 mm on longitudinal translation and 0.80 ± 0.39 • for rotations around the vertical axis. Furthermore, to showcase the relevance of the proposed framework, we evaluate the system's performance in the context of surgical procedures. This use case was designed to replicate the scenarios of k-wire insertions in orthopedic procedures. For evaluation, seven surgeons were provided with visual navigation and asked to perform 24 injections using the proposed framework. A second study with ten participants served to investigate the capabilities of the framework in the context of more general scenarios. Results from these studies provided comparable accuracy to those reported in the literature for AR-based navigation procedures.

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We describe a novel Convected Element Method (CEM) for simulation of formation of functional blood vessels induced by tumor-generated growth factors in a process called angiogenesis. Angiogenesis is typically modeled by a convection-diffusion-reaction equation defined on a continuous domain. A difficulty arises when a continuum approach is used to represent the formation of discrete blood vessel structures. CEM solves this difficulty by using a hybrid continuous/discrete solution method allowing lattice-free tracking of blood vessel tips that trace out paths that subsequently are used to define compact vessel elements. In contrast to more conventional angiogenesis modeling, the new branches form evolving grids that are capable of simulating transport of biological and chemical factors such as nutrition and anti-angiogenic agents. The method is demonstrated on expository vessel growth and tumor response simulations for a selected set of conditions, and include effects of nutrient delivery and inhibition of vessel branching. Initial results show that CEM can predict qualitatively the development of biologically reasonable and fully functional vascular structures. Research is being carried out to generalize the approach which will allow quantitative predictions.

Background Transforaminal percutaneous endoscopic lumbar surgeries (PELS) for lumbar disc herniation and spinal stenosis are growing in popularity. However, there are some problems in the establishment of the working channel and foraminoplasty such as nerve and blood vessel injuries, more radiation exposure, and steeper learning curve. Rapid technological advancements have allowed robotic technology to assist surgeons in improving the accuracy and safety of surgeries. Therefore, the purpose of this study is to develop a robot-assisted system for transforaminal PELS, which can provide navigation and foraminoplasty. Methods The robot-assisted system consists of three systems: preoperative planning system, navigation system, and foraminoplasty system. In the preoperative planning system, 3D visualization of the surgical segment and surrounding tissues are realized using the multimodal image fusion technique of Computed tomography and Magnetic resonance imaging, and the working channel planning is carried out to reduce the risk for injury to vital blood vessels and nerves. In the navigation system, the robot can obtain visual perception ability from a visual receptor and automatically adjust the robotic platform and robot arm to the appropriate positions according to the patient’s position and preoperative plan. In addition, the robot can automatically register the surgical target through intraoperative fluoroscopy. After that, the robot will provide navigation using the 6 degree-of-freedom (DOF) robot arm according to the preoperative planning system and guide the surgeon to complete the establishment of the working channel. In the foraminoplasty system, according to the foraminoplasty planning in the preoperative planning system, the robot performs foraminoplasty automatically using the high speed burr at the end of the robot arm. The system can provide real-time feedback on the working status of the bur through multi-mode sensors such as multidimensional force, position, and acceleration. Finally, a prototype of the system is constructed and performance tests are conducted. Discussion Our study will develop a robot-assisted system to perform transforaminal PELS, and this robot-assisted system can also be used for other percutaneous endoscopic spinal surgeries such as interlaminar PELS and percutaneous endoscopic cervical and thoracic surgeries through further research. The development of this robot-assisted system can be of great significance. First, the robot can improve the accuracy and efficiency of endoscopic spinal surgeries. In addition, it can avoid multiple intraoperative fluoroscopies, minimize exposure to both patients and the surgical staff, shorten the operative time, and improve the learning curve of beginners, which is beneficial to the popularization of percutaneous endoscopic spinal surgeries.

In a hollow microneedles for non-force fluid extraction and transfer, under the viscosity and capillary force, the fluid flow velocity varied following time. The fluid mechanical analysis couldn't apply the steady pipe flow model. In this paper, based on Newtonian fluid, a transient flow theoretical model was built to interpret microfluidic properties in the microneedle with the rectangular cross section for non-force fluid extraction and transfer, and the analytical solution for the marching position of fluid flow was obtained in order to study the relation between the flow variables and physical properties in pipe flow of a Newtonian fluid in the microneedle. The contact angles between the open surface of the microneedle and the different fluids, which were water, plasma, serum and whole blood, were measured using the CCD to approximate as the contact angles of the internal surface. For faster fluid filling into the microneedles, the length width ratio of the section of microchannel was optimized to 1 2 + .