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  • 1
    In: Sensors, MDPI AG, Vol. 20, No. 18 ( 2020-09-17), p. 5334-
    Abstract: We develop a stereo-multispectral endoscopic prototype in which a filter-wheel is used for surgical guidance to remove cholesteatoma tissue in the middle ear. Cholesteatoma is a destructive proliferating tissue. The only treatment for this disease is surgery. Removal is a very demanding task, even for experienced surgeons. It is very difficult to distinguish between bone and cholesteatoma. In addition, it can even reoccur if not all tissue particles of the cholesteatoma are removed, which leads to undesirable follow-up operations. Therefore, we propose an image-based method that combines multispectral tissue classification and 3D reconstruction to identify all parts of the removed tissue and determine their metric dimensions intraoperatively. The designed multispectral filter-wheel 3D-endoscope prototype can switch between narrow-band spectral and broad-band white illumination, which is technically evaluated in terms of optical system properties. Further, it is tested and evaluated on three patients. The wavelengths 400 nm and 420 nm are identified as most suitable for the differentiation task. The stereoscopic image acquisition allows accurate 3D surface reconstruction of the enhanced image information. The first results are promising, as the cholesteatoma can be easily highlighted, correctly identified, and visualized as a true-to-scale 3D model showing the patient-specific anatomy.
    Type of Medium: Online Resource
    ISSN: 1424-8220
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2052857-7
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  • 2
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2023
    In:  Current Directions in Biomedical Engineering Vol. 9, No. 1 ( 2023-09-01), p. 315-318
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 9, No. 1 ( 2023-09-01), p. 315-318
    Abstract: Surgical phase recognition is an important aspect of surgical workflow analysis, as it allows an automatic analysis of the performance and efficiency of surgical procedures. A big challenge for training a neural network for surgical phase recognition is the availability of training data and the large (visual) variability in procedures of different surgeons. Hence, a network must be able to generalize to new data. In this paper, we present an adaptation of a Temporal Convolutional Network for surgical phase recognition in order to ensure the generalization of the network to new scenes with different conditions on the example of cholecystectomy. We used publicly available datasets of 104 surgeries from four different centers for training. The results showed that the network was able to generalize to new scenes and we obtained recognition results with accuracy up to 82% on our own six captured surgeries, performed in a different hospital. This performance is similar for test data from the hospitals of the training data, suggesting that the network can well generalize to new surgical rooms and surgeons. The findings have important implications for the development of automated surgical decision support systems that can be applied in a variety of real-world surgical settings.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2023
    detail.hit.zdb_id: 2835398-5
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  • 3
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2023
    In:  Current Directions in Biomedical Engineering Vol. 9, No. 1 ( 2023-09-01), p. 571-574
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 9, No. 1 ( 2023-09-01), p. 571-574
    Abstract: The modified Allen test (MAT) is a widely used tool to examine the perfusion capacities of the arteries (ulnar or radial) of the hand. In clinical practice, MAT is utilized to ensure that in the event of occlusion, remaining vessels guarantee sufficient hand perfusion. This work shows that perfusion assessment via imaging photoplethysmography (iPPG) can be used to assess MAT. We captured the hands of seven subjects with a standard RGB camera while performing a MAT. Out of these captured video recordings, the iPPG signal was extracted via plane-orthogonal-to-skin transformation. Based on these extracted signals, we derive the heart rate, signal-to-noise ratio, DC parameter, and correlation with a reference iPPG signal to determine if an Allen test was pathological or inconspicuous. For all seven subjects, the results of our MAT assessment were identical to the medical expert’s assessment. This paper presents a procedure and initial thresholds for objectively evaluating and quantifying MAT.We show how globally and locally calculated parameters can be used to assess the perfusion of the investigated hand. This analysis makes it possible to quantify the exact point in time when the perfusion is again sufficient. If a reperfusion problem occurs, we are able to localize the spatial regions of occurrence. The presented hardware setup is affordable and can be easily installed and used in every doctor’s office.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2023
    detail.hit.zdb_id: 2835398-5
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  • 4
    Online Resource
    Online Resource
    SPIE-Intl Soc Optical Eng ; 2020
    In:  Journal of Medical Imaging Vol. 7, No. 06 ( 2020-11-19)
    In: Journal of Medical Imaging, SPIE-Intl Soc Optical Eng, Vol. 7, No. 06 ( 2020-11-19)
    Type of Medium: Online Resource
    ISSN: 2329-4302
    Language: Unknown
    Publisher: SPIE-Intl Soc Optical Eng
    Publication Date: 2020
    detail.hit.zdb_id: 2768118-X
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  • 5
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2021
    In:  Current Directions in Biomedical Engineering Vol. 7, No. 2 ( 2021-10-01), p. 456-459
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 7, No. 2 ( 2021-10-01), p. 456-459
    Abstract: Existing challenges in surgical education (See one, do one, teach one) as well as the Covid-19 pandemic make it necessary to develop new ways for surgical training. This is also crucial for the dissemination of new technological developments. As today’s live transmissions of surgeries to remote locations always come with high information loss, e.g. stereoscopic depth perception, and limited communication channels. This work describes the implementation of a scalable remote solution for surgical training, called TeleSTAR (Telepresence for Surgical Assistance and Training using Augmented Reality), using immersive, interactive and augmented reality elements with a bi-lateral audio pipeline to foster direct communication. The system uses a full digital surgical microscope with a modular software-based AR interface, which consists of an interactive annotation mode to mark anatomical landmarks using an integrated touch panel as well as an intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics.We broadcasted three cochlea implant surgeries in the context of otorhinolaryngology. The intervention scaled to five different remote locations in Germany and the Netherlands with lowlatency. In total, more than 150 persons could be reached and included an evaluation of a participant’s questionnaire indicating that annotated AR-based 3D live transmissions add an extra level of surgical transparency and improve the learning outcome.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
    detail.hit.zdb_id: 2835398-5
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  • 6
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2023
    In:  Current Directions in Biomedical Engineering Vol. 9, No. 1 ( 2023-09-01), p. 615-618
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 9, No. 1 ( 2023-09-01), p. 615-618
    Abstract: In image-guided surgery, imaging systems such as (stereo-)endoscopes allow intra-operative 3D reconstructions in form of point clouds. However, endoscopes provide only a narrow field of view, resulting in a confined point cloud. In this paper, we present an analysis and registration pipeline for confined point clouds acquired by stereo endoscopes into a fused representation. For a coarse registration, TEASER is applied, while a refinement is conducted utilizing point-to-plane ICP. The pipeline is tested on two datasets: acquired point clouds of a head phantom using a EinsteinVision ® 3.0 endoscope and point clouds from the Stereo Correspondence And Reconstruction of Endoscopic Data challenge. The results for both datasets show that 3D reconstructions of anatomical structures by utilizing stereo-endoscopes and point cloud registration is a promising contactless and radiation-free method. However, non-rigid deformations are not yet incorporated and evaluation of the method compared to reference data is challenging.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2023
    detail.hit.zdb_id: 2835398-5
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  • 7
    Online Resource
    Online Resource
    SPIE-Intl Soc Optical Eng ; 2019
    In:  Journal of Biomedical Optics Vol. 24, No. 12 ( 2019-12-3), p. 1-
    In: Journal of Biomedical Optics, SPIE-Intl Soc Optical Eng, Vol. 24, No. 12 ( 2019-12-3), p. 1-
    Type of Medium: Online Resource
    ISSN: 1083-3668
    Language: Unknown
    Publisher: SPIE-Intl Soc Optical Eng
    Publication Date: 2019
    detail.hit.zdb_id: 2001934-8
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  HNO Vol. 70, No. S1 ( 2022-02), p. 1-7
    In: HNO, Springer Science and Business Media LLC, Vol. 70, No. S1 ( 2022-02), p. 1-7
    Abstract: Nasal septum perforations (NSP) have many uncomfortable symptoms for the patient and a highly negative impact on quality of life. NSPs are closed using patient-specific implants or surgery. Implants are created either under anesthesia using silicone impressions or using 3D models from CT data. Disadvantages for patient safety are the increased risk of morbidity or radiation exposure. Materials and methods In the context of otorhinolaryngologic surgery, we present a gentle approach to treating NSP with a new image-based, contactless, and radiation-free measurement method using a 3D endoscope. The method relies on image information only and makes use of real-time capable computer vision algorithms to compute 3D information. This endoscopic method can be repeated as often as desired in the clinical course and has already proven its accuracy and robustness for robotic-assisted surgery (RAS) and surgical microscopy. We expand our method for nasal surgery, as there are additional spatial and stereoperspective challenges. Results After measuring 3 relevant parameters (NSP extension: axial, coronal, and NSP circumference) of 6 patients and comparing the results of 2 stereoendoscopes with CT data, it was shown that the image-based measurements can achieve comparable accuracies to CT data. One patient could be only partially evaluated because the NSP was larger than the endoscopic field of view. Conclusion Based on the very good measurements, we outline a therapeutic procedure which should enable the production of patient-specific NSP implants based on endoscopic data only.
    Type of Medium: Online Resource
    ISSN: 0017-6192 , 1433-0458
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1459183-2
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  • 9
    In: Journal of Telemedicine and Telecare, SAGE Publications
    Abstract: Existing challenges in surgical education (See one, do one, teach one) as well as the COVID-19 pandemic make it necessary to develop new ways for surgical training. Therefore, this work describes the implementation of a scalable remote solution called “TeleSTAR” using immersive, interactive and augmented reality elements which enhances surgical training in the operating room. The system uses a full digital surgical microscope in the context of Ear–Nose–Throat surgery. The microscope is equipped with a modular software augmented reality interface consisting an interactive annotation mode to mark anatomical landmarks using a touch device, an experimental intraoperative image-based stereo-spectral algorithm unit to measure anatomical details and highlight tissue characteristics. The new educational tool was evaluated and tested during the broadcast of three live XR-based three-dimensional cochlear implant surgeries. The system was able to scale to five different remote locations in parallel with low latency and offering a separate two-dimensional YouTube stream with a higher latency. In total more than 150 persons were trained including healthcare professionals, biomedical engineers and medical students.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2007700-2
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  • 10
    Online Resource
    Online Resource
    Walter de Gruyter GmbH ; 2021
    In:  Current Directions in Biomedical Engineering Vol. 7, No. 2 ( 2021-10-01), p. 464-467
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 7, No. 2 ( 2021-10-01), p. 464-467
    Abstract: We present a stereo-multispectral microscope equipped with an additional illumination unit allowing further narrow-band illumination in the spectral range of 400n.m up to 800nm. The combination of the normal microscope illumination with the multispectral light unit allows different illumination modalities to be realized, which enables intraoperative spectral tissue analysis with direct visualization. Two illumination methods were tested in two cholesteatoma surgeries. In addition, two cholesteatom samples were illuminated and analyzed ex vivo. Cholesteatoma showed :fluorescent characteristics in our ex vivo analysis. This behavior could be used intraoperatively using a combination of white light and strong near-UV to blue illumination to highlight cholesteatoma tissue in the microscopic image. Thus, the visual differentiability of different tissue types can be improved and the clinical decision-making process can be accelerated.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
    detail.hit.zdb_id: 2835398-5
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