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

In recent years, image-guided percutaneous (through the skin) needle-based surgery has become part of routine clinical practice in performing procedures such as biopsies, injections and therapeutic implantations. The number of these procedures can be measured by the millions in Canada. They are usually performed under some image guidance, such as computed tomography, magnetic resonance imaging, ultrasound, or fluoroscopy, with the primary goal of navigating a needle to target while sparing healthy and/or critical structures. Existing surgical guidance methods are usually analyzed in an informal manner, usually in isolation from other comparable modalities. Due to the lack of comprehensive performance measurement infrastructure, quantitative surgical skill assessment and training in alternative surgical guidance techniques is not possible.   The system we propose, the Percutaneous Infrastructure and Testbed (Perk Kit) system, will record surgical intent, motion, technical performance and outcome relative to the surgical plan. It will also record perceptual information and various qualitative parameters, permitting large-scale ergonomic studies directly related to quantitative performance. Perk Kit will promote rapid design and prototyping of innovative needle-based surgical guidance systems and, consequently, will lead to accelerated translation to clinical practice. Perk Kit will be truly unique in that it will implement image overlay, biplane laser guidance, tracked navigation, and a host of conventional modalities, such as tracked freehand navigation, handheld needle guides, and the fully unassisted freehand approach, as baseline, thereby assuring a common platform for surgical guidance system and operator performance analysis.   Constructing, maintaining and enhancing the system will provide many opportunities for training HQP. Perk Kit also promises to have a positive impact on training for medical students, surgical residents and medical postdoctoral fellows who will learn to work with innovative surgical navigation methods.