From medical images to minimally invasive intervention: Computer assistance for robotic surgery

Minimally invasive surgery has been established as an important way forward in surgery for reducing patient trauma and hospitalization with improved prognosis. The introduction of robotic assistance enhances the manual dexterity and accuracy of instrument manipulation. Further development of the field in using pre- and intra-operative imaging guidance requires the integration of the general anatomy of the patient with clear pathologic indications and geometrical information for preoperative planning and intrai-operative manipulation. It also requires effective visualization and the recreation of haptic and tactile sensing with dynamic active constraints to improve consistency and safety of the surgical procedures. This paper describes key technical considerations of tissue deformation tracking, 3D reconstruction, subject-specific modeling, image guidance and augmented reality for robotic assisted minimally invasive surgery. It highlights the importance of adapting preoperative surgical planning according to intra-operative data and illustrates how dynamic information such as tissue deformation can be incorporated into the surgical navigation framework. Some of the recent trends are discussed in terms of instrument design and the usage of dynamic active constraints and human-robot perceptual docking for robotic assisted minimally invasive surgery. (C) 2009 Elsevier Ltd. All rights reserved.