Surgical Audio Guidance SurAG: Extracting Non-Invasively Meaningful Guidance Information During Minimally Invasive Procedures

Illanes, Alfredo; Sühn, Thomas; Esmaeili, Nazila; Maldonado, Iván; Schaufler, Anna; Chen, Chien-Hsi; Boese, Axel; Friebe, Michael

doi:10.1109/bibe.2019.00108

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Considering the results obtained with this methodology [10,11] on other surgical instruments, classification of tissue properties, and relevant events such as unintended injuries is conceivable. Audio guidance stands out from other approaches because it can be easily integrated into clinical operations and used with existing instruments.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

Schaufler

Illanes

Maldonado

et al. 2020

Current Directions in Biomedical Engineering

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In robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.

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Section: Discussionmentioning

confidence: 99%

“…Here, audio has proved to be a tool with a high potential for providing guidance information such as tissue-tissue passage, puncture and perforation events, and palpation information. [10,11].…”

Section: Introductionmentioning

confidence: 99%

Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

Schaufler

Illanes

Maldonado

et al. 2020

Current Directions in Biomedical Engineering

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“…As an example, an adapted version of the system is used for the acquisition of vibroacoustic signals originating from instrument-tissueinteractions in the field of minimally invasive surgery. [27][28][29]…”

Section: Dovepressmentioning

confidence: 99%

<p>Auscultation System for Acquisition of Vascular Sounds – Towards Sound-Based Monitoring of the Carotid Artery</p>

Sühn

Spiller

Salvi

et al. 2020

MDER

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Introduction Atherosclerotic diseases of the carotid are a primary cause of cerebrovascular events such as stroke. For the diagnosis and monitoring angiography, ultrasound- or magnetic resonance-based imaging is used which requires costly hardware. In contrast, the auscultation of carotid sounds and screening for bruits – audible patterns related to turbulent blood flow – is a simple examination with comparably little technical demands. It can indicate atherosclerotic diseases and justify further diagnostics but is currently subjective and examiner dependent. Methods We propose an easy-to-use computer-assisted auscultation system for a stable and reproducible acquisition of vascular sounds of the carotid. A dedicated skin-transducer-interface was incorporated into a handheld device. The interface comprises two bell-shaped structures, one with additional acoustic membrane, to ensure defined skin contact and a stable propagation path of the sound. The device is connected wirelessly to a desktop application allowing real-time visualization, assessment of signal quality and input of supplementary information along with storage of recordings in a database. An experimental study with 5 healthy subjects was conducted to evaluate usability and stability of the device. Five recordings per carotid served as data basis for a wavelet-based analysis of the stability of spectral characteristics of the recordings. Results The energy distribution of the wavelet-based stationary spectra proved stable for measurements of a particular carotid with the majority of the energy located between 3 and 40 Hz. Different spectral properties of the carotids of one individual indicate the presence of sound characteristics linked to the particular vessel. User-dependent parameters such as variations of the applied contact pressure appeared to have minor influence on the general stability. Conclusion The system provides a platform for reproducible carotid auscultation and the creation of a database of pathological vascular sounds, which is a prerequisite to investigate sound-based vascular monitoring.

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“…In order to overcome these drawbacks, an audio-based technique has recently been introduced in [11]. This concept consists of listening to the instrument's tip-tissue interactions with an audio sensor located at the proximal end of the instrument.…”

Section: Introductionmentioning

confidence: 99%

Study of needle punctures into soft tissue through audio and force sensing: can audio be a simple alternative for needle guidance?

et al. 2021

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Purpose Percutaneous needle insertion is one of the most common minimally invasive procedures. The clinician’s experience and medical imaging support are essential to the procedure’s safety. However, imaging comes with inaccuracies due to artifacts, and therefore sensor-based solutions were proposed to improve accuracy. However, sensors are usually embedded in the needle tip, leading to design limitations. A novel concept was proposed for capturing tip–tissue interaction information through audio sensing, showing promising results for needle guidance. This work demonstrates that this audio approach can provide important puncture information by comparing audio and force signal dynamics during insertion. Methods An experimental setup for inserting a needle into soft tissue was prepared. Audio and force signals were synchronously recorded at four different insertion velocities, and a dataset of 200 recordings was acquired. Indicators related to different aspects of the force and audio were compared through signal-to-signal and event-to-event correlation analysis. Results High signal-to-signal correlations between force and audio indicators regardless of the insertion velocity were obtained. The force curvature indicator obtained the best correlation performances to audio with more than $$70\%$$ 70 % of the correlations higher than 0.6. The event-to-event correlation analysis shows that a puncture event in the force is generally identifiable in audio and that their intensities firmly related. Conclusions Audio contains valuable information for monitoring needle tip/tissue interaction. Significant dynamics obtained from a well-known sensor as force can also be extracted from audio, regardless of insertion velocities.

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Surgical Audio Guidance SurAG: Extracting Non-Invasively Meaningful Guidance Information During Minimally Invasive Procedures

Cited by 8 publications

References 7 publications

Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures

<p>Auscultation System for Acquisition of Vascular Sounds – Towards Sound-Based Monitoring of the Carotid Artery</p>

Study of needle punctures into soft tissue through audio and force sensing: can audio be a simple alternative for needle guidance?

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