(Left to right) Mechanical engineering
graduate researcher Vasile Nistor and professor Greg Carman, computer
science professor Petros Faloutsos, and Dr. Eric Dutson.
Guided Surgery Tool Brings Expertise to Remote Locations
Collaborative System Offers New Training Method Researchers at the UCLA Henry Samueli School of
Engineering and Applied Science, working with laparoscopic surgeons,
have developed a new method of guided surgery that will permit
experienced surgeons to guide surgeries in remote locations, such
as battlefield hospitals.
“Laparoscopic surgery is a specialized field
that requires a lot of practice,” noted Greg Carman, professor
of mechanical and aerospace engineering. “To develop a way
in which the best surgeon in the world can assist with a surgery
remotely holds the potential to revolutionize the field.”
Laparoscopic surgery is a minimally invasive procedure
in which surgeons use a video camera to view the area in which
they are working. The two-dimensional field of vision and limited
range of movement make it a more difficult type of surgery.
The new telementoring system developed by the
UCLA Engineering researchers allows highly trained surgeons to
aid battlefield surgeons with laparoscopic procedures using video
conferencing tools to provide live guidance.
“Our system replaces robotic surgery tools,
which pose challenges associated with power supplies, ease of
use, space constraints, and cost,” said mechanical engineering
graduate student researcher Vasile “Licã” Nistor.
“Using this new method, a highly qualified surgeon could
provide guidance from a remote location to an on-site generalist
at a much lower cost.”
Because of the considerable variation from operation
to operation, it’s critical to have an expert surgeon available
who can offer guidance and advice in real time. A modified video
conferencing system offers a way to present information to the
on-site surgeon in a useful way that does not interrupt the surgery.
“We’ve found that because laparoscopic
surgery is 2-D and not 3-D, it’s analogous to playing video
games,” said computer science graduate student Brian Allen.
“We’d like to find a way to use the graphic technologies
that enhance video games to enhance the surgical procedure.”
The system developed at UCLA also can be used
to train residents and new surgeons in laparoscopic surgery.
“We have not radically altered the training
process, and have modified tools that are routinely used by surgeons,”
said Allen. “Our system is affordable, easy to set up and
use, and needs less space than current training methods.”
“Our goal is to replicate airline training,
providing a high quality virtual environment and realistic simulations,”
explained Nistor. “Right now, the medical industry is about
20-30 years behind the airlines, and we’d like to provide
a system that can quantify a trainee’s skill level.”
To create practice simulations for medical residents,
the team has developed a  program
to track the movement of the surgical tools that have been modified
with a set of seamlessly integrated motion tracking sensors. The
sensors measure rotation, position of the instruments, and other
movement. By tracking both the expert and the novice, they can
see where someone learning might have difficulties, or need more
training during the
simulations.
“We have been working closely with UCLA
surgeon Dr. Erik Dutson, an expert in laparoscopic surgery,”
said computer science professor Petros Faloutsos. “By recording
his movements, we have an expert benchmark that we can use for
training.”
The system tracks motion over time, showing both
movement and steadiness in the hand that is not in use.
“It’s very difficult to not move the
off-hand,” said Allen, “but critical since a wrong
movement can accidentally cause a cut in the surrounding tissue
out of sight of the camera, creating a chance of infection.”
To counter what is statistically
the major cause of failure for this type of surgery, the group
has added a kinesthetic force feedback component to the system
that will help constrain accidental movement outside areas designated
by an expert surgeon. A surgeon would feel resistance if he or
she accidentally moved their off-hand into a critical area, for
instance, the liver to one side of a gall bladder.
The guided laparoscopic surgery project is funded by the U.S.
Army’s Telemedicine and Advanced Technologies Research Center.
The UCLA Engineering researchers are collaborating with members
of UCLA’s Center for Advanced Surgical and Interventional
Technology (CASIT). The facility includes a da Vinci surgical
robotic surgery system, a human patient simulator, and laparoscopic
surgical simulators and tools.
###
Above: Dr. Eric Dutson
and mechanical and aerospace engineering
professor Greg Carman practice on the guided surgery demonstration.
Images: Don Liebig
|
