Wundows複合機能システム

Wundows複合機能システム

Thursday, September 12, 2013

With the tablet PC, we have the tools right at the operating table

Tablet PC in the Operating Room: “With the tablet PC, we have the tools right at the operating table” 09/09/2013 Prof. Karl J. Oldhafer; © private The liver is an organ interwoven with numerous blood vessels. Approximately one and a half liters of blood flow through it every minute. This is why it creates a big challenge for surgeons – especially if a tumor needs to be removed. Researchers at the Fraunhofer Institute for Medical Image Computing (MEVIS) have now developed an app that illustrates a 3D reconstruction of the liver structure. The surgeon sees the vessel structures on a tablet PC placed over the organ, as if he/she were able to look inside the organ past the liver surface. Professor Karl J. Oldhafer of the Asklepios Clinics in Hamburg, Germany, has tested the technology in his operation room and now reports on his impressions. MEDICA.de: Professor Oldhafer, what does the new tablet app by the Fraunhofer MEVIS enable you to do as a liver surgeon in the operating room? Karl J. Oldhafer: The liver is an organ with a closed surface. With the naked eye, we are not able to see where the vessels are located on the inside and how close they are to the tumor that needs to be removed. The new technology is able to illustrate and make these anatomical structures visible during surgery. MEDICA.de: How is the app being used during liver surgery? Oldhafer: We first collect all of the necessary image data of the patient such as CT data for instance. The app is then able to illustrate a 3D organ reconstruction based on the data. We can see all the important liver vessels, tumors as well as the distance between tumors and vessels on this 3D model. During the surgery, the surgeon holds the tablet PC over the liver and records images with the integrated camera. He/she then views the 3D reconstruction on the real image. This makes it possible for the surgeon to see the structures as if he/she were able to look inside the organ past the liver surface. MEDICA.de: What advantage does this technology bring to the surgeon? Oldhafer: We are able to make the surgery safer with this new app. Our orientation is improved and we know where the important vessels are located. Above all, the app supports the surgeon. We also have the opportunity to see where the vessels are located through other techniques like intraoperative ultrasound, but it is more complicated. Thanks to this app and the tablet PC, the data is available much faster. We can enlarge the view on the touch screen if we need to or we can obliterate removed tissue. This way we always have an accurate view of what is happening inside the organ. The new app enables surgeons to take the work they previously did on the computer into the operating room, project it onto the liver and implement it; © Fraunhofer MEVIS/ Fabian Bimmer MEDICA.de: How do you normally proceed during liver resection surgery? Oldhafer: We usually first memorize the CT image data and visualize the organ in our head. We can then correlate it with the intraoperative ultrasound during the surgery and orient ourselves with it. The new app enables surgeons to take the work they previously did on the computer into the operating room, project it onto the liver and implement it. This makes the surgical intervention much easier for the surgeon and therefore safer for the patient. MEDICA.de: How long have you been using the tablet PC in your operating room? Oldhafer: We have only been able to use the tablet PC in the operating room for a short time. However, the technology that is behind it has been constantly developed since the 90s. Developing the software for the 3D reconstruction was an important research focus at the Fraunhofer MEVIS. MEDICA.de: What are the chances of this new technology becoming accepted in clinical practice? Oldhafer: I see a huge potential for this procedure, since it is very easy to use. Even though it does not enable us to operate on tumors we were previously not able to remove, this technology does however simplify liver surgery. It makes it possible to better implement surgical steps. Until now, we have used 3D reconstruction on a PC outside of the operating room. Now we are able to take it into the operating room and have the tools right at the operating table and not on the computer at our desks. It is also conceivable to use this technology for surgery on other organs such as the pancreas for instance. The interview was conducted by Michalina Chrzanowska and translated by Elena O'Meara. MEDICA.de

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