COMPUTER AIDED SURGERY FOR ASSISTING MINIMALLY INVASIVE THERAPIES
University of Tokyo, Japan
Minimally invasive therapy such as endoscopic surgery and catheter based intervention are being spread in many surgical intervention fields. Thus engineering assistance is important to realize safe and effective minimally invasive therapy. Computer Assisted Surgical guidance such as surgical navigation is one of key technologies. It is expected that application of robotic technology to minimally invasive surgery will provide the following functions:
(1) Precise manipulation of biological tissues and surgical instruments in narrow and confined surgical field.
(2) Precise and accurate localization of therapeutic devices using various pre and intra-operative medical information.
In the first mode of application, more compact system is required. It can be realized by introduction of novel mechanical design and application off a new mechanism as well as new materials. At the same time integration with various energy devices are also required. Intra-operative guidance utilizing various pre and intra operative information is necessary in the second mode of application. Image guided robotic system for RF ablation, laser ablation, intensity modified radiation therapy, and high intensity focused ultrasound. In this type of robot, various preand intraoperative information including functional information is used to navigate the therapeutic devices to the target lesion. Intra-operative identification of pathological state of the target tissue and evaluation of outcome after therapeutic intervention are also important.
Factors limiting the application of surgical navigation systems and medical robotics include limited usability requiring additional procedures for preparation, and high costs. Recent progress of computer vision technologies will solve part of these issues.
For wider spread of these technologies in clinical environment, further improvement of usability, cost reduction, and accumulation of clinical evidences demonstrating efficacy from both clinical and economical point of view are required.