PLANNING AND LEADERSHIP FOR A BETTER WORLD
PLANNING AND LEADERSHIP FOR A BETTER WORLD Today heart operations must be performed after the heart has been intentionally stopped by the surgeon, but with the assistance of a robot, future heart surgery will be performed on beating hearts.
The technique has yet to be tried on real patients, but French researchers report in the International Journal of Robotics Research that they have developed a three-dimensional computer model that will allow surgeons to direct a robot in performing surgery on a beating heart.
Developed by France's Montpellier Laboratory of Informatics, Robotics, and Microelectronics, the 3D computer model predicts the movements of the heart as it beats so that the robot can move its tools in perfect synchronization with each beat. Once the robot has begun running its compensation algorithms, the human surgeon will be able to perform the procedure as if the heart were stationary, according to researchers Rogerio Richa, Philippe Poignet and Chao Liu, who developed the 3D model that tracks the heart's motion as it beats.
The technique will not work on all heart surgery procedures, at least not today, but procedures on less invasive surface structures of the heart could soon be performed on millions of patients each year without the unnecessary risk of stopping their heart.
The technique uses active cancellation of cardiac motions, as well as the movement of a patient's chest wall during breathing, by combining an algorithm for 3D tracking of the heart surface using a thin-plate spline deformable model with an illumination-compensation algorithm that compensates for subtle changes in lighting. All information is gathered using the 3D stereoscopic cameras, which can accurately gauge depth, on the DaVinci surgical robot from Intuitive Surgical (Sunnyvale, Calif.).
Previous efforts at creating an algorithm to perform active cancellation during surgical procedures have tried to get by with traditional two-dimensional camera information, but have been unable to keep up with a heart's movement in real time. The new model, on the other hand, predicts the next likely movements of the heart, then precisely tracks its real motion with DaVinci's 3D cameras, thereby enabling it to keep up. While the robot continually adjusts to heart and chest movements during surgery, a compensated image provided to surgeons allows them to view the heart as if it were stationary while performing the surgical procedure.
The task of compensating for movement was complicated by the heart's irregular shape and its tendency to expand outward in all directions during beating. Ordinary algorithms that depend on stationary reference points could not be used. However, the thin plate spline deformable model, according to the scientists, has successfully isolated the physical movements of the heart and lungs during surgical simulations.
Next, the group plans to incorporate the algorithm into the controller of a DaVinci robot, using a graphic processing unit to accelerate its calculations for real-time tracking.
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