Intraoperative tissue classification methods in orthopedic and neurological surgeries: A systematic review

Abstract

Accurate tissue differentiation during orthopedic and neurological surgeries is critical, given that such surgeries involve operations on or in the vicinity of vital neurovascular structures and erroneous surgical maneuvers can lead to surgical complications. By now, the number of emerging technologies tackling the problem of intraoperative tissue classification methods is increasing. Therefore, this systematic review paper intends to give a general overview of existing technologies. The review was done based on the PRISMA principle and two databases: PubMed and IEEE Xplore. The screening process resulted in 60 full-text papers. The general characteristics of the methodology from extracted papers included data processing pipeline, machine learning methods if applicable, types of tissues that can be identified with them, phantom used to conduct the experiment, and evaluation results. This paper can be useful in identifying the problems in the current status of the state-of-the-art intraoperative tissue classification methods and designing new enhanced techniques.

State-of-the-Art of Non-Radiative, Non-Visual Spine Sensing with a Focus on Sensing Forces, Vibrations and Bioelectrical Properties: A Systematic Review

“…However, only the surgeon's visual sense is aided through this technology, while tactile and auditory feedback are also hindered in MISS. Several review studies have shown that, for the proper intraoperative tissue classification, it is essential to use a combination of sensing techniques from different modalities to mimic our human ability to combine our different senses in a decision-making process and to accommodate for the much-needed sensor redundancy in complex surgical tasks [10,11]. According to Qu et al the future direction for spine research should focus on information processing through multisensor technology to ensure effectiveness and safety as tissue recognition is affected by differences in surgical instruments, operating methods, surgical paths, operating speeds, and other factors [10].…”

“…As the visual field is limited in spine surgery and there is a shift towards MISS, this study focuses on non-visual, non-radiative technology. The investigated categories of sensing methods were based on two review studies on tissue classification methods in spine surgery [10,11]. The three categories include the sensing of force and torque, sound and vibration, and bioelectrical properties.…”