Surgery is a complex task. Even if the surgery is successful, complications can occur, and even the best surgeons can fail. Surgeons must rely on visual cues and their own experience to avoid nerve or blood vessel damage. Mistakes can turn a simple surgery into a more difficult one.
Unfortunately, many of these potential dangers lurk below the tissue surface and remain hidden from surgeons until modern imaging technology reveals them.
Kai Zhang, associate professor at Worcester Polytechnic Institute, will present his research integrating photoacoustic (PA) imaging into robot-assisted surgery on Monday, May 11 at 8:40 a.m. ET as part of the 190th Annual Acoustical Society of America Conference, May 11-15.
Robot-assisted laparoscopic surgery is abdominal or pelvic surgery that uses a small camera called a laparoscope that is inserted through a small incision. Smaller incisions mean less pain and faster recovery time for patients, and robotic assistance means more control and precision for surgeons. Unfortunately, the risk of damaging subsurface anatomical structures remains.
Accidental severing of hidden vessels during robot-assisted laparoscopy occurred at a rate of 1% to 2%, depending on the procedure. Additionally, such accidents can lead to various complications, including bleeding, paralysis, and in the worst cases, fatal consequences. ”
Kai Zhang, Associate Professor, Worcester Polytechnic Institute
One new solution is PA imaging. This technique shines a laser deep into the tissue, which absorbs the light and generates sound waves. These sound waves are picked up by ultra-sensitive microphones and can be used to pinpoint subsurface structures such as blood vessels and nerve bundles.
“This feature allows visualization of the implanted anatomical structures and their depth location, which is extremely valuable for surgical planning and intraoperative monitoring,” said Zhang.
Zhang incorporated PA imaging into the laparoscopic surgery workflow to help guide the surgeon during the procedure. He analyzed data from the PA probe and used it to create a 3D representation of the neurovascular bundle. Neurovascular bundles are collections of nerves and blood vessels that surgeons want to avoid at all costs. These representations were then superimposed on video from the laparoscopic camera to provide a real-time augmented reality video feed.
Zhang tested the technology during radical prostatectomy, a surgery to remove prostate cancer, but PA imaging has broader applications than this surgery.
“We expect this image measurement device to be easily applicable to other image-guided surgeries as well as other laparoscopic surgeries,” said Zhang.
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Acoustical Society of America

