The OntoSPM Collaborative Action has been in operation for 24 months, with a growing dedicated membership. Its main result is a modular ontology, undergoing constant updates and extensions, based on the experts' suggestions. It remains an open collaborative action, which always welcomes new contributors and applications.

An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

Purpose In the context of aviation and automotive navigation technology, assistance functions are associated with predictive planning and wayfinding tasks. In endoscopic minimally invasive surgery, however, assistance so far relies primarily on image-based localization and classification. We show that navigation workflows can be described and used for the prediction of navigation steps. Methods A natural description vocabulary for observable anatomical landmarks in endoscopic images was defined to create 3850 navigation workflow sentences from 22 annotated functional endoscopic sinus surgery (FESS) recordings. Resulting FESS navigation workflows showed an imbalanced data distribution with over-represented landmarks in the ethmoidal sinus. A transformer model was trained to predict navigation sentences in sequence-to-sequence tasks. The training was performed with the Adam optimizer and label smoothing in a leave-one-out cross-validation study. The sentences were generated using an adapted beam search algorithm with exponential decay beam rescoring. The transformer model was compared to a standard encoder-decoder-model, as well as HMM and LSTM baseline models. Results The transformer model reached the highest prediction accuracy for navigation steps at 0.53, followed by 0.35 of the LSTM and 0.32 for the standard encoder-decoder-network. With an accuracy of sentence generation of 0.83, the prediction of navigation steps at sentence-level benefits from the additional semantic information. While standard class representation predictions suffer from an imbalanced data distribution, the attention mechanism also considered underrepresented classes reasonably well. Conclusion We implemented a natural language-based prediction method for sentence-level navigation steps in endoscopic surgery. The sentence-level prediction method showed a potential that word relations to navigation tasks can be learned and used for predicting future steps. Further studies are needed to investigate the functionality of path prediction. The prediction approach is a first step in the field of visuo-linguistic navigation assistance for endoscopic minimally invasive surgery.

BackgroundMedical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention).MethodsIn this paper, we present an ontology and an ontology-based software system, which can identify risks across medical processes and supports the avoidance of errors in particular in the perioperative setting. We developed a practicable definition of the risk notion, which is easily understandable by the medical staff and is usable for the software tools. Based on this definition, we developed a Risk Identification Ontology (RIO) and used it for the specification and the identification of perioperative risks.ResultsAn agent system was developed, which gathers risk-relevant data during the whole perioperative treatment process from various sources and provides it for risk identification and analysis in a centralized fashion. The results of such an analysis are provided to the medical personnel in form of context-sensitive hints and alerts. For the identification of the ontologically specified risks, we developed an ontology-based software module, called Ontology-based Risk Detector (OntoRiDe).ConclusionsAbout 20 risks relating to cochlear implantation (CI) have already been implemented. Comprehensive testing has indicated the correctness of the data acquisition, risk identification and analysis components, as well as the web-based visualization of results.

Abstract Background: The design and internal layout of modern operating rooms (OR) are influencing the surgical team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. Results The implementation of improved OR setups reduced the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortened the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.