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Telematic support for image guided surgery

Health care telematics has recently become one of the most important sources of innovation. Particularly, advances in the field of Image-Guided Therapy lend themselves readily to surgery, radiology, and imaging sciences. A relevant project, entitled “European applications in surgical interventions” (EASI), provides guidance and support throughout the multi-interdisciplinary surgical tasks involved.


The EASI project has resulted in the development of two demonstrators: the EasyVision for pre-operative planning and post-operative follow-up, and the EasyGuide for intra-operative navigation. Within the context of pre-operative planning, the methods widely used in the areas of multi-modality image segmentation, registration and visualisation, have been extended and validated towards image-guided surgery. Hence, a correlation between prior three-dimensional viewing of a lesion in its spatial relationship to its anatomical environment (organs, vessels, nerves) may confirm a thorough and efficient pre-operative surgical plan for transfer into the operating room via registration tools. During surgery, the plan is verified and, if necessary, updated with the aid of an optical localiser that tracks the positioning of surgical tools, whose viewing is then added on patient images in real time. Ultimately, the surgeon is aware of the exact location and the orientation of the tools in reference to the patient's anatomy and pathology. Thus, patient risks are reduced and the quality of the intervention is improved, especially, when changes have occurred in relevance to a re-oriented anatomy, or as a result of surgery itself. Within the EASI project two representative fields have been addressed: neuro and vascular surgery. In neurosurgery, EASI demonstrators have been used in both open and frameless stereotactic procedures providing unlimited accuracy of localisation and navigation for the first procedure and turning the second into a more patient-friendly procedure prior to the operation by providing feedback in real-time. In vascular surgery, particularly in the area of treatment of abdominal aorta aneurysms (inserting a vessel prosthesis to avoid rupturing), EASI demonstrators provide safe and effective pre-operative and intra-operative image guidance to surgeons, who are able to predict the outcome and contribute to the education of trainees in this new technique, by using pre-operative simulation of both graft and surgery. EASI demonstrators can optimise the cost-effectiveness of clinical interventions, while reducing patient risks. Both demonstrators' software has been combined in a common software platform that resembles the product for further exploitation. Demonstrators incorporate the clinical requirements specifications of the specific applications. However, by revealing the demonstrators to a larger clinical user group, a better insight can be gained concerning the commercial potential of the application field concerning its specific functionality.

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