Evaluating the impact of image guidance in the surgical setting: a systematic review

Dilley, James; Camara, Mafalda; Ismail, Omar; Carter, Alex; Pratt, Philip J.; Vale, Justin; Darzi, Ara; Mayer, Erik

doi:10.1007/s00464-019-06876-x

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Image-guided surgery technologies intend to improve the surgeon’s ability to identify and optimally remove the tissue of interest [ 31 ]. In the current study, we were thus challenged by the question: How can we go above and beyond the recently CE-marked DROP-IN gamma probe concept that we have been exploring since 2014?…”

Section: Discussionmentioning

confidence: 99%

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making

Azargoshasb

Alphen

Slof

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Decision-making and dexterity, features that become increasingly relevant in (robot-assisted) minimally invasive surgery, are considered key components in improving the surgical accuracy. Recently, DROP-IN gamma probes were introduced to facilitate radioguided robotic surgery. We now studied if robotic DROP-IN radioguidance can be further improved using tethered Click-On designs that integrate gamma detection onto the robotic instruments themselves. Methods Using computer-assisted drawing software, 3D printing and precision machining, we created a Click-On probe containing two press-fit connections and an additional grasping moiety for a ProGrasp instrument combined with fiducials that could be video tracked using the Firefly laparoscope. Using a dexterity phantom, the duration of the specific tasks and the path traveled could be compared between use of the Click-On or DROP-IN probe. To study the impact on surgical decision-making, we performed a blinded study, in porcine models, wherein surgeons had to identify a hidden 57Co-source using either palpation or Click-On radioguidance. Results When assembled onto a ProGrasp instrument, while preserving grasping function and rotational freedom, the fully functional prototype could be inserted through a 12-mm trocar. In dexterity assessments, the Click-On provided a 40% reduction in movements compared to the DROP-IN, which converted into a reduction in time, path length, and increase in straightness index. Radioguidance also improved decision-making; task-completion rate increased by 60%, procedural time was reduced, and movements became more focused. Conclusion The Click-On gamma probe provides a step toward full integration of radioguidance in minimal invasive surgery. The value of this concept was underlined by its impact on surgical dexterity and decision-making.

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Section: Discussionmentioning

confidence: 99%

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making

Azargoshasb

Alphen

Slof

et al. 2021

Eur J Nucl Med Mol Imaging

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“…Because of these many confounding factors, the accuracy of soft tissue IGS systems has mainly been assessed in phantoms [20] . In prior work, we employed phantoms to assess multiple aspects of our IGS system including initial touch-based registration [10] , periodic re-registration [21] , and system impact on surgeon ability [22] .…”

Section: Introductionmentioning

confidence: 99%

A Safe Framework for Quantitative In Vivo Human Evaluation of Image Guidance

Cannon

Ferguson

Pitt

et al. 2024

IEEE Open J. Eng. Med. Biol.

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We present a new framework for in vivo image guidance evaluation and provide a case study on robotic partial nephrectomy. Methods: This framework (called the "bystander protocol") involves two surgeons, one who solely performs the therapeutic process without image guidance, and another who solely periodically collects data to evaluate image guidance. This isolates the evaluation from the therapy, so that in-development image guidance systems can be tested without risk of negatively impacting the standard of care. We provide a case study applying this protocol in clinical cases during robotic partial nephrectomy surgery. Results: The bystander protocol was performed successfully in 6 patient cases. We find average lesion centroid localization error with our IGS system to be 6.5 mm in vivo compared to our prior result of 3.0 mm in phantoms. Conclusions: The bystander protocol is a safe, effective method for testing in-development image guidance systems in human subjects.

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“…The main advantage of this technique is that it imitates human vision and takes advantage of a large amount of information from the environment [23]. In recent years, visual servo has found many application scenarios in medical robot navigation, but its practical clinical implementation remains rare [24]. Image-based visual servo (IBVS) does not rely on accurate depth measurement [25,26], so it began to be used in procedures that lose depth perception such as minimally invasive surgery (MIS).…”

Section: Introductionmentioning

confidence: 99%

An Uncalibrated Image-Based Visual Servo Strategy for Robust Navigation in Autonomous Intravitreal Injection

Luo

Feng

et al. 2022

Electronics

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Autonomous intravitreal injection in ophthalmology is a challenging surgical task as accurate depth measurement is difficult due to the individual differences in the patient’s eye and the intricate light reflection or refraction of the eyeball, often requiring the surgeon to first preposition the end-effector accurately. Image-based visual servo (IBVS) control does not rely on depth information, exhibiting potential for addressing the issues mentioned above. Here we describe an enhanced IBVS strategy to achieve high performance and robust autonomous injection navigation. The radial basis function (RBF) kernel with strong learning capability and fast convergence is used to globally map the uncertain nonlinear strong coupling relationship in complex uncalibrated IBVS control. The Siamese neural network (SNN) is then used to compare and analyze the characteristic differences between the current and target poses, thus making an approximation of the mapping relationships between the image feature changes and the end-effector motion. Finally, a robust sliding mode controller (SMC) based on min–max robust optimization is designed to implement effective surgical navigation. Data from the simulation and the physical model experiments indicate that the maximum localization and attitude errors of the proposed method are 0.4 mm and 0.18°, exhibiting desirable accuracy with the actual surgery and robustness to disturbances. These results demonstrate that the enhanced strategy can provide a promising approach that can achieve a high level of autonomous intravitreal injection without a surgeon.

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Evaluating the impact of image guidance in the surgical setting: a systematic review

Cited by 3 publications

References 21 publications

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making

The Click-On gamma probe, a second-generation tethered robotic gamma probe that improves dexterity and surgical decision-making

A Safe Framework for Quantitative In Vivo Human Evaluation of Image Guidance

An Uncalibrated Image-Based Visual Servo Strategy for Robust Navigation in Autonomous Intravitreal Injection

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