Sensors management in robotic neurosurgery: The ROBOCAST project

Abstract

Abstract-Robot and computer-aided surgery platforms bring a variety of sensors into the operating room. These sensors generate information to be synchronized and merged for improving the accuracy and the safety of the surgical procedure for both patients and operators. In this paper, we present our work on the development of a sensor management architecture that is used is to gather and fuse data from localization systems, such as optical and electromagnetic trackers and ultrasound imaging devices. The architecture follows a modular client-server approach and was implemented within the EU-funded project ROBOCAST (FP7 ICT 215190). Furthermore it is based on very well-maintained open-source libraries such as OpenCV and Image-Guided Surgery Toolkit (IGSTK), which are supported from a worldwide community of developers and allow a significant reduction of software costs.We conducted experiments to evaluate the performance of the sensor manager module. We computed the response time needed for a client to receive tracking data or video images, and the time lag between synchronous acquisition with an optical tracker and ultrasound machine.Results showed a median delay of 1.9 ms for a client request of tracking data and about 40 ms for US images; these values are compatible with the data generation rate (20-30 Hz for tracking system and 25 fps for PAL video).Simultaneous acquisitions have been performed with an optical tracking system and US imaging device: data was aligned according to the timestamp associated with each sample and the delay was estimated with a cross-correlation study. A median value of 230 ms delay was calculated showing that realtime 3D reconstruction is not feasible (an offline temporal calibration is needed), although a slow exploration is possible. In conclusion, as far as asleep patient neurosurgery is concerned, the proposed setup is indeed useful for registration error correction because the brain shift occurs with a time constant of few tens of minutes. A. Enquobahrie is with Kitware Inc., Carrboro, NC, USA Thus, the need for different sensors in the operating room (OR) has highly increased in the past two decades with the purpose of improving the accuracy and the safety of surgical procedures for both patients and operators. The main typologies of sensors used in the OR include localization systems, inertial sensors, force sensors, and intra-operative imaging devices. Surgical navigation systems usually rely on information acquired using localization systems (mechanical, optical, or electromagnetic) in order to localize the pose of surgical instruments and to overlay them on the CT or MR images to assist surgeons during procedures [4].Inertial Measurement Unit (IMU) allows for determination of an object's position and orientation at a high rate, even with no line of sight; on the other hand, IMUs are limited by noise amplification and drift, due to the double integration of the acceleration signal. They have recently been proposed in robotic surgery, in addition to an optical tracking system, ...

On Providing Multi-Level Quality of Service for Operating Rooms of the Future

“…The literature corpus after application of all filters includes 31 articles. The contents of these studies are further analyzed to identify the main focus of the studies, which are:Patient monitoring: [38,39,40,41,42];Device integration and data interoperability: [43,44,45,46,47,48,49];Smart hospitals: [50,51,52];Operating Room monitoring (Intelligent OR): [18,19,20,21,22,23,24,25,26,27,28];QoS-Aware Middlewares: [53,54,55,56,57]. …”

“…The “Operating Room monitoring (Intelligent OR)” group presents studies that demonstrate attempts on employing tracking technologies in surgeries to improve procedures. Basically, they focus mainly on two different goals: ( i ) activity recognition [18,19,20]; and ( ii ) personnel and equipment tracking [20,21,22,23,24,25,26,27,28]. The former group is composed of articles focusing on identifying the actions, which medical staff perform during surgeries.…”

“…Besides RFID, Computer Vision techniques are present in 18% of the studies. In particular, Vaccarella et al [21] focus on robotic systems for neurosurgery in which they integrate RTLS systems and Computer Vision techniques in real time. Regardless the technology, the majority of studies present concerns about real-time issues.…”

“…Currently, most studies aiming at providing medical systems for ORs focus on describing architectures for data monitoring [18,19,20,21,22,23,24,25,26,27,28]. However, they do not address QoS mechanisms in their solutions, which, to the best of our knowledge, indicates a lack of studies focusing on this significant topic for patient safety.…”