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A haptics-assisted cranio-maxillofacial surgery planning system for restoring skeletal anatomy in complex trauma cases
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
2013 (English)In: International Journal of Computer Assisted Radiology and Surgery, ISSN 1861-6410, E-ISSN 1861-6429, Vol. 8, no 6, 887-894 p.Article in journal (Refereed) Published
Abstract [en]

Cranio-maxillofacial (CMF) surgery to restore normal skeletal anatomy in patients with serious trauma to the face can be both complex and time-consuming. But it is generally accepted that careful pre-operative planning leads to a better outcome with a higher degree of function and reduced morbidity in addition to reduced time in the operating room. However, today's surgery planning systems are primitive, relying mostly on the user's ability to plan complex tasks with a two-dimensional graphical interface. A system for planning the restoration of skeletal anatomy in facial trauma patients using a virtual model derived from patient-specific CT data. The system combines stereo visualization with six degrees-of-freedom, high-fidelity haptic feedback that enables analysis, planning, and preoperative testing of alternative solutions for restoring bone fragments to their proper positions. The stereo display provides accurate visual spatial perception, and the haptics system provides intuitive haptic feedback when bone fragments are in contact as well as six degrees-of-freedom attraction forces for precise bone fragment alignment. A senior surgeon without prior experience of the system received 45 min of system training. Following the training session, he completed a virtual reconstruction in 22 min of a complex mandibular fracture with an adequately reduced result. Preliminary testing with one surgeon indicates that our surgery planning system, which combines stereo visualization with sophisticated haptics, has the potential to become a powerful tool for CMF surgery planning. With little training, it allows a surgeon to complete a complex plan in a short amount of time.

Place, publisher, year, edition, pages
2013. Vol. 8, no 6, 887-894 p.
National Category
Medical Image Processing Surgery
Identifiers
URN: urn:nbn:se:uu:diva-198977DOI: 10.1007/s11548-013-0827-5ISI: 000326455900002PubMedID: 23605116OAI: oai:DiVA.org:uu-198977DiVA: diva2:618834
Available from: 2013-04-21 Created: 2013-04-30 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Haptics with Applications to Cranio-Maxillofacial Surgery Planning
Open this publication in new window or tab >>Haptics with Applications to Cranio-Maxillofacial Surgery Planning
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Virtual surgery planning systems have demonstrated great potential to help surgeons achieve a better functional and aesthetic outcome for the patient, and at the same time reduce time in the operating room resulting in considerable cost savings. However, the two-dimensional tools employed in these systems today, such as a mouse and a conventional graphical display, are difficult to use for interaction with three-dimensional anatomical images. Therefore surgeons often outsource virtual planning which increases cost and lead time to surgery.

Haptics relates to the sense of touch and haptic technology encompasses algorithms, software, and hardware designed to engage the sense of touch. To demonstrate how haptic technology in combination with stereo visualization can make cranio-maxillofacial surgery planning more efficient and easier to use, we describe our haptics-assisted surgery planning (HASP) system. HASP supports in-house virtual planning of reconstructions in complex trauma cases, and reconstructions with a fibula osteocutaneous free flap including bone, vessels, and soft-tissue in oncology cases. An integrated stable six degrees-of-freedom haptic attraction force model, snap-to-fit, supports semi-automatic alignment of virtual bone fragments in trauma cases. HASP has potential beyond this thesis as a teaching tool and also as a development platform for future research.

In addition to HASP, we describe a surgical bone saw simulator with a novel hybrid haptic interface that combines kinesthetic and vibrotactile feedback to display both low frequency contact forces and realistic high frequency vibrations when a virtual saw blade comes in contact with a virtual bone model. 

We also show that visuo-haptic co-location shortens the completion time, but does not improve the accuracy, in interaction tasks performed on two different visuo-haptic displays: one based on a holographic optical element and one based on a half-transparent mirror. 

Finally, we describe two prototype hand-worn haptic interfaces that potentially may expand the interaction capabilities of the HASP system. In particular we evaluate two different types of piezo-electric motors, one walking quasi-static motor and one traveling-wave ultrasonic motor for actuating the interfaces.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 1289
Keyword
medical image processing, haptics, haptic rendering, haptic gripper, visuo-haptic co-location, vibrotactile feedback, surgery simulation, virtual surgery planning, cranio-maxillofacial surgery
National Category
Medical Image Processing Human Computer Interaction
Research subject
Computerized Image Processing
Identifiers
urn:nbn:se:uu:diva-262378 (URN)978-91-554-9339-4 (ISBN)
Public defence
2015-10-16, Room 2247, Polacksbacken, Lägerhyddsvägen 2, Uppsala, 10:00 (English)
Opponent
Supervisors
Available from: 2015-09-25 Created: 2015-09-14 Last updated: 2015-10-01Bibliographically approved

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Olsson, PontusNysjö, FredrikHirsch, Jan-MichaélCarlbom, Ingrid B.

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