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COMPUTER ASSISTED SURGERY OVERVIEW



Abstract

At present, multi-modality medical imaging including x-ray, fluoroscopy, ultrasound, CT, MRI, etc. allows to efficiently diagnose and plan for the majority of surgical interventions. So far, the resulting preoperative set of diagnostic and planning information could not be directly transformed to the real situation in the operating theatre. Additionally, there is a need to improve the accuracy and safety of surgical actions.

In the past few years a novel area of research and development – Computer Assisted Orthopaedic Surgery (CAOS) – has been established. Its primary goal is to provide a direct link between preoperative planning and intraoperative surgical action through advanced image-interactive surgical navigation. In addition, the use of computer hard- and software is promoted to enhance patient treatment and care pre- and postoperatively and to provide improved education and training of surgeons as well as advanced case documentation.

In this presentation an overview of the state of the art in CAOS research and development is given. Initial focus will be on image-interactive navigation based on preoperatively acquired three-dimensional tomographic image data sets. These techniques require intraoperatively a surgeon-generated transformation between the surgical object and the associated image based virtual object, the so-called registration procedure. Medical robots or free-hand navigation systems are then used to image-interactively perform various surgical actions. In addition, a novel approach to computer assisted orthopaedic surgery will be described, in which intraoperative images, such as ultrasound, endoscopy and fluoroscopy or ‘surgeon-defined anatomy’ complement or replace preoperatively acquired three-dimensional tomographic image data. Various applications for both strategies will be presented in different anatomical areas, such as spine, hip, shoulder, and knee. Surgical interventions ranging from joint reconstruction and replacement to trauma treatment will be covered.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.