| Gabor Fichtinger, a faculty
member at the NSF-funded Engineering Research Center (ERC) for Computer-Integrated
Surgical Systems and Technology (CISST) at Johns Hopkins University (JHU),
and colleagues John Carrino (JHU Radiology), Paweena U-Thainual (Queen’s
University), Iulian Iordachita (JHU), and Siddharth Vikal (Queen’s
University) have developed the Perk Station, an inexpensive, simple, and
easily reproducible surgical navigation workstation for practicing percutaneous
(through-the-skin) surgeries in a laboratory setting with non-biohazardous
specimens.
Image-guided, needle-based
surgery has become part of routine clinical practice in performing procedures
such as biopsies, injections, and therapeutic implants. Trainees
typically perform percutaneous needle interventions under the supervision
of a senior physician, which is a slow training process that lacks an objective
and quantitative assessment of the surgical skill and performance demonstrated.
The Perk Station is designed as a replicable and adaptable tool for teaching
computer-assisted surgery at all levels, from high-school science classes
to clinical residency. Small, portable, and lightweight, the Perk
Station will fit inside a suitcase when disassembled and promises to serve
the education and outreach mission of the CISST ERC.
The Perk Station (see figure)
comprises image overlay, laser overlay, and standard tracked freehand navigation
in a single suite. The image overlay consists of a flat display and
a half-silvered mirror mounted on a gantry. When the physician trainee
looks at the patient through the mirror, the CT/MR image appears to be
floating inside the body with the correct size and position, as if the
physician had 2D “X-ray vision.” The laser overlay uses two laser
planes – one transverse plane and one oblique sagittal plane. The
intersection of these two laser planes marks the needle insertion path.
A stand-alone laptop computer is used for image transfer, surgical planning,
and appropriate rendering. The image overlay is mounted on one side
with the laser overlay and tracked navigation system on the opposite side,
so the user can swap between guidance techniques by turning the system
around. The surgical planning and control interface is based on 3D
Slicer, the open-source medical image computing and visualization software.
The Perk Station is fully
designed and awaiting manufacture. The system made its debut in undergraduate
teaching during Fall 2008 at Queen’s University and was presented at the
2008 SMIT (Society for Medical Innovation and Technology) conference.
To promote complete transferability, the design of the Perk Station – including
hardware blueprints, phantom blueprints, and software source code – will
be made publicly available as open source. The system’s simple design
and low cost allow interested parties to replicate the hardware and install
the software. Further, CT/MRI data and pre-made surgical plans will
also be provided, so users may operate the Perk Station without having
to access medical imaging facilities. |
