Grant: Research Tools and Instruments - Category 1 (<$150,000)

Advances in video imaging have played a key role in bringing forth the widespread use of Minimally Invasive Surgery (MIS) in a variety of procedures such as cardiology, neurosurgery, orthopaedics, urology and oncology. However, the inherent difficulties of MIS techniques have traditionally imposed limitations on their applicability. Reduced instrumental control and freedom, combined with unusual hand-to-eye coordination and limited view of the operating field, enforce restrictions on the surgeon and require considerable dexterity and skill. On the other hand, these procedures entail several benefits for the patient and the healthcare system: smaller incisions, minimal blood loss, preservation of normal tissue, reduced pain, and shortened recovery and rehabilitation times. To help make the MIS techniques easier to apply and learn, and by the same token to facilitate their more widespread use, an enhanced reality surgical system to restore depth and context information would be useful. The challenges involved in realizing this goal are related to the realism of data visualization, the robust reconstruction of patient-specific models and the registration between different imaging modalities. Furthermore, the focus of recent research has been the development of more accurate and less invasive methods for the registration of preoperative models to intra-operative models of the patient in the operating room. Therefore, ultrasound has been chosen as a non-invasive alternative for localizing bone and other surfaces in the operating room.  The requested equipment will allow us to investigate new approaches to ensure accurate registration of patient data from different modalities, which is a prerequisite for intra-operative assistance.  3D pre-operative models of the spine obtained from MRI volumetric data and surface data from ultrasound will be combined with intra-operative 2D thoracoscopic images. This multimodal image fusion framework will provide complementary visual information including soft tissues and bones in a single view, thus reducing cognitive effort on the part of the surgeon.