Per-Operative Guidance

Motivations: Non invasive techniques commonly used for diagnosis and therapy include laparoscopic surgery and interventional radiology. While both approaches can be used for the treatment of hepatic tumors, laparoscopy is by far the most commonly used. However, hepatic resection and tumor removal using a laparoscopic approach remains a major challenge. Besides the requirement for advanced technical skills, the main issue is the transfer of the planned resection strategy (performed on the pre-operative data) into the operating field. While resection planes, vascular structures and tumors can be identified in the pre-operative CT or MR scan, and potentially reconstructed in 3D, they cannot be visualized during the procedure. To overcome this issue, a number of research groups are developing augmented reality techniques to overlay vessels, tumors and cutting planes onto the laparoscopic video. However, current techniques are limited to a rigid registration of the pre-operative liver anatomy onto the intra-operative image, and often this registration is not performed automatically. The objective of this work is to develop an automatic, real-time, non-rigid registration and tracking of the intra and pre-operative liver data.

Cataract Surgery

Motivations: Cataract surgery has made important advances over the past twenty years, and every year, more than five million people in the United States and in Europe undergo cataract surgery. This procedure is however complex to perform as it requires good hand-eye coordination as well as accurate microscopic manipulations of surgical instruments. Therefore a long training period is mandatory to acquire these necessary skills. Current method of training are based on companionship and this apprenticeship model depends on the availability of the instructor and potentially exposes patients to complications due to the inexperience of the operator. In this context, recent reports have demonstrated the advantages and added value of computer-based simulation over conventional training.Therefore, new training simulation systems for cataract surgery have been recently developed. Typically, these simulators offer a combination of simulation software that aims at reproducing some parts of the cataract surgery procedure and hardware devices that allow the surgeons for realistic interaction with the simulation.

Interventional Radiology

Motivations: many vascular pathologies can now be operated on in a non invasive way thanks to interventional radiology. Using such technique, therapeutic tools are inserted within the arteries, up to the lesion through a catheter. As a particular case, intracranial aneurysms present like herniae onto the arterial wall. The endovascular treatment consists in filling the aneurismal cavity by placing coils. These are sorts of long platinum springs that, once deployed, wind into a compact ball. Considering the location of the lesion, close to the brain, and its small size, a few millimeters, the interventional gesture requires a good planning and cannot but be performed by a very experienced surgeon. A simulation tool of the interventional act, available in the operating room, reliable, adapted to the patient's anatomy and physiology, would help to plan the coil placement, train the surgeon, and improve the medical training to the technique.