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3. A remote and immersive setup for pandemic-safe surgical education

Author

Rosenthal Jean-Claude, Schneider Armin, Wisotzky Eric L., Meij Senna, Dobbelsteen John van den, Arens Philipp, and Uecker Florian C.

Subjects
surgical education, covid-19, remote surgery, telepresence, augmented reality (ar), stereoscopic imaging, 3d reconstruction, multi-spectral imaging, Medicine
Abstract

Existing challenges in surgical education (See one, do one, teach one) as well as the Covid-19 pandemic make it necessary to develop new ways for surgical training. This is also crucial for the dissemination of new technological developments. As today’s live transmissions of surgeries to remote locations always come with high information loss, e.g. stereoscopic depth perception, and limited communication channels. This work describes the implementation of a scalable remote solution for surgical training, called TeleSTAR (Telepresence for Surgical Assistance and Training using Augmented Reality), using immersive, interactive and augmented reality elements with a bi-lateral audio pipeline to foster direct communication. The system uses a full digital surgical microscope with a modular software-based AR interface, which consists of an interactive annotation mode to mark anatomical landmarks using an integrated touch panel as well as an intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics.We broadcasted three cochlea implant surgeries in the context of otorhinolaryngology. The intervention scaled to five different remote locations in Germany and the Netherlands with lowlatency. In total, more than 150 persons could be reached and included an evaluation of a participant’s questionnaire indicating that annotated AR-based 3D live transmissions add an extra level of surgical transparency and improve the learning outcome.

Published
2021
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4. Therapeutic prostate cancer interventions: a systematic review on pubic arch interference and needle positioning errors.

Author

Bloemberg, Jette, de Vries, Martijn, van Riel, Luigi A. M. J. G., de Reijke, Theo M., Sakes, Aimée, Breedveld, Paul, and van den Dobbelsteen, John J.

Subjects
PROSTATE, PROSTATE cancer, RADIOISOTOPE brachytherapy, CANCER treatment, PHYSICIANS
Abstract

Introduction: This study focuses on the quantification of and current guidelines on the hazards related to needle positioning in prostate cancer treatment: (1) access restrictions to the prostate gland by the pubic arch, so-called Pubic Arch Interference (PAI) and (2) needle positioning errors. Next, we propose solution strategies to mitigate these hazards. Methods: The literature search was executed in the Embase, Medline ALL, Web of Science Core Collection*, and Cochrane Central Register of Controlled Trials databases. Results: The literature search resulted in 50 included articles. PAI was reported in patients with various prostate volumes. The level of reported PAI varied between 0 and 22.3 mm, depending on the patient's position and the measuring method. Low-Dose-Rate Brachytherapy induced the largest reported misplacement errors, especially in the cranio-caudal direction (up to 10 mm) and the largest displacement errors were reported for High-Dose-Rate Brachytherapy in the cranio-caudal direction (up to 47 mm), generally increasing over time. Conclusions: Current clinical guidelines related to prostate volume, needle positioning accuracy, and maximum allowable PAI are ambiguous, and compliance in the clinical setting differs between institutions. Solutions, such as steerable needles, assist in mitigating the hazards and potentially allow the physician to proceed with the procedure. This systematic review was performed in accordance with the PRISMA guidelines. The review was registered at Protocols.io (DOI: dx.doi.org/10.17504/protocols.io.6qpvr89eplmk/v1). [ABSTRACT FROM AUTHOR]

Published
2024
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14. MR‑guided HDR prostate brachytherapy with teleoperated steerable needles

Author

de Vries, M., Wijntjes, M., Sikorski, J., Moreira, P., van de Berg, Nick, van den Dobbelsteen, John J., Misra, S., de Vries, M., Wijntjes, M., Sikorski, J., Moreira, P., van de Berg, Nick, van den Dobbelsteen, John J., and Misra, S.

Abstract

Conformity of tumour volumes and dose plans in prostate brachytherapy (BT) can be constrained by unwanted needle deflections, needle access restrictions and visualisation limitations. This work validates the feasibility of teleoperated robotic control of an active steerable needle using magnetic resonance (MR) for guidance. With this system, perturbations can be counteracted and critical structures can be circumvented to access currently inaccessible areas. The system comprises of (1) a novel steerable needle, (2) the minimally invasive robotics in an MR environment (MIRIAM) system, and (3) the daVinci Research Kit (dVRK). MR scans provide visual feedback to the operator controlling the dVRK. Needle steering is performed along curved trajectories to avoid the urethra towards targets (representing tumour tissue) in a prostate phantom with a targeting error of 1.2 ± 1.0 mm. This work shows the potential clinical applicability of active needle steering for prostate BT with a teleoperated robotic system in an MR environment.

Published
2023

20. A Laparoscopic Grasper Handle with Integrated Augmented Tactile Feedback, Designed for Training Grasp Control

Author

Westebring-van der Putten, Eleonora, Hajian, Mostafa, Goossens, Richard, van den Dobbelsteen, John, Jakimowicz, Jack, Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Nierstrasz, Oscar, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Sudan, Madhu, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Vardi, Moshe Y., Series editor, Weikum, Gerhard, Series editor, Kappers, Astrid M. L., editor, van Erp, Jan B. F., editor, Bergmann Tiest, Wouter M., editor, and van der Helm, Frans C. T., editor

Published
2010
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29. CoBra robot for localized cancer treatment and diagnosis under real-time MRI guidance

Author

Dhaliwal, Sepaldeep Singh, Wilby, Sarah, de Vries, Martijn, Brou Boni, Kévin, Firouzy, Sina, Escaida Navarro, Stefan, Belarouci, Abdelkader, Coelen, Vincent, Lakhal, Othman, Pasquier, David, Palmer, Antony, Polak, Wojciech, Jones, Dylan, Labib, Ashraf, Dobbelsteen, John, Sanz Lopez, Mario, Duriez, Christian, Reynaert, Nick, Merzouki, Rochdi, Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Portsmouth Hospitals NHS Trust, Delft University of Technology (TU Delft), Cancer Oscar Lambret [Lille], University of Portsmouth, Deformable Robots Simulation Team (DEFROST ), Inria Lille - Nord Europe, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Portsmouth Business School [Portsmouth], Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB), Institut Jules Bordet [Bruxelles], and Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)

Subjects
[SPI]Engineering Sciences [physics], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2021

30. MRI-Guided Robotic Prostate Biopsy and Brachytherapy: Update from the EU funded CoBra Project

Author

Wilby, Sarah, Dhaliwal, Sepaldeep Singh, Van Den Dobbelsteen, John, Firouzy, Sina, Hodgson, Dominic, Jones, Dylan, Labib, Ashraf, Nagar, Yoodhvir, Palmer, Antony, Polak, Wojciech, De Vries, Martijn, Wiskerke, Pieter, Merzouki, Rochdi, Portsmouth Hospitals NHS Trust, University of Portsmouth, Centre de Recherche en Informatique, Signal et Automatique de Lille - UMR 9189 (CRIStAL), Centrale Lille-Université de Lille-Centre National de la Recherche Scientifique (CNRS), and Delft University of Technology (TU Delft)

Subjects
[SPI]Engineering Sciences [physics], [INFO]Computer Science [cs], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; The Interreg 2 Seas (EU)-funded CoBra research initiative is a five year project to develop a novel device for MR-guided robotic biopsy and brachytherapy for prostate cancer. We report on research achievements at two years into the work. We present details from several of the work packages: 1) MRI-safe I-125 seed delivery module, based on Piezoelectric motors, and evaluation of MR seed artefact in the closed loop control of the MR-guided robot; 2) MRI-safe pneumatic biopsy system; 3) novel steerable needles developed to improve access to all parts of the prostate; 4) prototype trajectory planning for ideal needle paths from an optimal number of insertion points; and 5) phantoms designed to test MR image quality in the presence of needles and seeds.

Published
2021

32. Block-matching-based registration to evaluate ultrasound visibility of percutaneous needles in liver-mimicking phantoms

Author

Sánchez-Margallo, Juan A., Tas, Lisette, Moelker, Adriaan, van den Dobbelsteen, John J., Sánchez-Margallo, Francisco M., Langø, Thomas, van Walsum, Theo, van de Berg, Nick J., Sánchez-Margallo, Juan A., Tas, Lisette, Moelker, Adriaan, van den Dobbelsteen, John J., Sánchez-Margallo, Francisco M., Langø, Thomas, van Walsum, Theo, and van de Berg, Nick J.

Abstract

Purpose: To present a novel methodical approach to compare visibility of percutaneous needles in ultrasound images. Methods: A motor-driven rotation platform was used to gradually change the needle angle while capturing image data. Data analysis was automated using block-matching-based registration, with a tracking and refinement step. Every 25 frames, a Hough transform was used to improve needle alignments after large rotations. The method was demonstrated by comparing three commercial needles (14G radiofrequency ablation, RFA; 18G Trocar; 22G Chiba) and six prototype needles with different sizes, materials, and surface conditions (polished, sand-blasted, and kerfed), within polyvinyl alcohol phantom tissue and ex vivo bovine liver models. For each needle and angle, a contrast-to-noise ratio (CNR) was determined to quantify visibility. CNR values are presented as a function of needle type and insertion angle. In addition, the normalized area under the (CNR-angle) curve was used as a summary metric to compare needles. Results: In phantom tissue, the first kerfed needle design had the largest normalized area of visibility and the polished 1 mm diameter stainless steel needle the smallest (0.704 ± 0.199 vs. 0.154 ± 0.027, p < 0.01). In the ex vivo model, the second kerfed needle design had the largest normalized area of visibility, and the sand-blasted stainless steel needle the smallest (0.470 ± 0.190 vs. 0.127 ± 0.047, p < 0.001). As expected, the analysis showed needle visibility peaks at orthogonal insertion angles. For acute or obtuse angles, needle visibility was similar or reduced. Overall, the variability in needle visibility was considerably higher in livers. Conclusion: The best overall visibility was found with kerfed needles and the commercial RFA needle. The presented methodical approach to quantify ultrasound visibility allows comparisons of (echogenic) needles, as well as other technological innovations aiming to improve ultrasound visibility o

Published
2021

41. Deep learning for surgical phase recognition using endoscopic videos

Author

Guédon, Annetje C. P., primary, Meij, Senna E. P., additional, Osman, Karim N. M. M. H., additional, Kloosterman, Helena A., additional, van Stralen, Karlijn J., additional, Grimbergen, Matthijs C. M., additional, Eijsbouts, Quirijn A. J., additional, van den Dobbelsteen, John J., additional, and Twinanda, Andru P., additional

Published
2020
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