3-D visualization for minimally invasive robotic coronary artery bypass (MIRCAB)

摘要

Conventional coronary bypass surgery involves invasive procedures such as sternotomy and cardiopulmonary bypass that encumber patients with high trauma and lengthy hospital stays. We are involved in pioneering efforts in minimally invasive robotic coronary artery bypass (MIRCAB) surgery. Our cardiothoracic surgical team at London Health Science Centre has successfully performed the world's first beating-heart MIRCAB using the Zeus Robotic Surgical System which involves robotic instruments inserted through tiny incisions between the ribs via thoracic ports. Thus, MIRCAB patients receive minimal incisions leading to improved recovery time. Despite the success of MIRCAB, surgeons still require better visualization tools for pre-surgical planning, to determine for example a patient's suitability for MIRCAB by examining the topology of his/her thorax cavity. We are adapting visualization techniques for MIRCAB. Cross-sectional thorax scans acquired with CT and ECG-gated MRI, are segmented using mathematical morphology algorithms, and the 3D images are integrated with our surgical planning platform. Within this environment, we may simulate the position of the robotic surgical tools and endoscopes, such that they are optimally positioned with respect to the target vessels for surgery.