Journal of Computer Aided Surgery Vol.6 No.2


肺の四次元モデリング −構造機能ナビゲーションへの可能性−
Four-dimensional Modeling of the Lung ; Potential for Structural-functional Navigation Surgery

北岡裕子a
a 大阪大学大学院 医学系研究科情報薬理学講座

Hiroko Kitaoka a
a Department of Information Pharmacology, Graduate School of Medicine, Osaka University

Abstract: Not only structural navigation, but also functional navigation should be developed for cardiac and pulmonary surgeries, because those organs function by deforming their own configurations. In order to obtain functional information during surgery, computational biomechanics will be useful. We have been constructing a 4D lung model which links its function with its structure under normal and abnormal conditions. Our model will be useful for developing a structural-functional navigator for lung surgery.

Keywords: 4D modeling, lung, ventilation distribution, emphysema, reduction surgery.


腹腔鏡手術の術者インターフェースについて
The Surgeon-Robot Interface for Controlling the Position of a Laparoscope

西川敦a
a 大阪大学大学院 基礎工学研究科機能創成専攻

Atsushi Nishikawa a
a Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University

Abstract: Robotic laparoscope positioners are now accepted and expected as assistant devices for solo surgery among endoscopic surgeons. In such robotic systems, the human-machine (surgeon-robot) interface is of paramount importance because it is the means by which the surgeon communicates with and controls the robotic camera assistant. Various types of human-machine interfaces such as remote hand switches, instrument-mounted joysticks, foot pedals, voice recognition, head/face control and instrument tracking have been suggested, and their effectiveness has been discussed individually. This paper attempts to bring together the human-machine interface in robotic camera positioning systems that have been devised in the last ten years. I herein organize the survey by breaking the laparoscope positioning systems into the following three types based on the view of "autonomy" : (i) non-autonomous systems, (ii) semi-autonomous systems, and (iii) full-autonomous systems.

Keywords: Human-machine interface, Laparoscopicsurgery, Robotic camera assistant, Solo surgery,Autonomy.


インターベンショナルMRI −物理計測の立場から−
Interventional MRI -Instrumentation Engineering Side-

黒田 輝 a,b
a 財団法人先端医療振興財団映像医療研究部
b 東海大学電子情報学部情報科学科

Kagayaki Kuroda a,b
a Department of Image-based Medicine, Institute of Biomedical Research and Innovation
b Department of Human and Information Sciences, The Faculty of Electronic Information, Tokai University

Abstract: Magnetic Resonance Imaging (MRI) is unique for interventional use in that it has a spatial resolution independent of the wave length of the electromagnetic field used for imaging, various image parameters relating to physical properties of the subject, superior soft-tissue contrast, freedom in slicing angle, and non-radiation nature. Total treatment assistance based on lesion identification, treatment planning, device tracking, temperature imaging and treatment assessment is possible with these features. In this article, a few latest topics in the interventional MRI are introduced with a short review of the instrumentation engineering aspect of the techniques.

Keywords: Interventional, MR, tracking, Temperature, Endoscope.


Open MRを用いた手術ナビゲーション
Navigation Surgery Using an Open MR System

森川茂廣a, 犬伏俊郎a, 来見良誠b, 椎野顕彦b, 佐藤浩一郎b, 出村公一b, Hasnine A Haque c, 徳田淳一d, 波多伸彦d
a 滋賀医科大学 MR医学総合研究センター
b 滋賀医科大学 医学部
c GE横河メディカルシステム
d 東京大学大学院 情報理工学系研究科

Shigehiro Morikawa a, Toshiro Inubushi a, Yoshimasa Kurumi b, Akihiko Shiino b, Koichiro Sato b, Koichi Demura b, Hasnine A Haque c, Junichi Tokuda d, Nobuhiko Hata d
a Biomedical MR Science Center, Shiga University of Medical Science School of Medicine
b Shiga University of Medical Science
c GE Yokogawa Medical Systems
d Graduate School of Information Science and Technology, The University of Tokyo

Abstract: Under real-time MR image navigation using a double-donut type open MR system, various surgical procedures, such as microwave thermocoagulation therapy of liver tumors, have been carried out for 4.5 years. We have developed new MR compatible surgical instruments and navigation software by ourselves. Such devices have been increased the availability of MR-guided procedures and quite effective for the accurate and safe treatment.

Keywords: MR image-guided surgery, Navigation surgery, Interventional therapy, Microwave ablation.


脊椎外科手術における術中イメージの重要性とナビゲーションシステムの必要性
Operative Imaging and Navigation System for Spinal Surgery

浅見尚規a
a 宮崎大学 医学部 脳神経外科
Naoki Asami a
a Department of Neurosurgery, Faculty of Medicine, University of Miyazaki

Keywords: Spinal instrumentation, Fluoroscopy, Navigation system.


耳鼻咽喉科領域におけるナビゲーションサージャリー
Navigational Surgery in Otorhinolaryngology

友田幸一a, 村田英之a, 石政 寛a
a 金沢医科大学 感覚機能病態学耳鼻咽喉科

Koichi Tomoda a*, Hideyuki Murata a, Hiroshi Ishimasa a
a Department of Otolaryngology, Kanazawa Medical University

Abstract: Application of navigation systems to otorhinolaryngology head and neck surgery should permit safer, sounder operations when attempting revision surgery on anatomically ambiguous target organs, surgery on lesions expanding to organs with risk factors for complications, and in minimally invasive surgery. If such systems were used in ear surgery, the location of important organs in the temporal bone could be checked. In operations on the nose or paranasal sinus at risk organs could be avoided (e.g. orbit and basal skull) and residual cells and incision locations on postoperative cyst could be identified. When operating tumors of head and neck, the preoperative and pretreatment status could be grasped and the area of tumors resection could be determined, including the safety margin. In addition to these applications, navigation systems are useful for operations such as choanal atresia and aural atresia, fracture repair, skull base surgery, and on biopsy, nerve block and surgical training. Although this system has the potential to improve the surgeon’s confidence and knowledge of patient anatomy, the overestimate its ability should be careful without any knowledge of anatomy and surgical experiences.

Keywords: Navigational Surgery, Indication, Problems, Educational tool, Future.


一般外科領域におけるナビゲーションサージェリー
Minimally Invasive Tailor-made Surgery for Colorectal Cancer Navigated by Integrated 3D-CT Imaging

奥田準二a,松木 充b,楢林 勇b,谷川允彦a
a 大阪医科大学 一般・消化器外科学教室
b 大阪医科大学 放射線医学教室

Junji Okuda a, Mitsuru Matsuki b, Isamu Narabayashi b, Nobuhiko Tanigawa a
a Department of General & Gastroenterological Surgery, Osaka Medical College
b Department of Radiology, Osaka Medical College

Abstract: For advanced right colon cancer, we perform lymph node dissection exposing so called the surgical trunk. For the resection of advanced proximal sigmoid cancer, we sometimes perform lymph node dissection around root of IMA with preserving the left colic artery and superior rectal artery. For either of these procedures performing safely, it is important to know the precise individual vascular anatomy bearing their variations. However, there are major issues in laparoscopic surgery, such as no tactile sensation, limitation on visual fields. To overcome these issues and to accurately identify the vascular anatomy of each patient, we have applied Integrated 3D-CT as preoperative simulation and intraopetative navigation since July, 2000. Under the precise recognition of laparoscopic surgical anatomy, additionally simulated and navigated by Integrated 3D-CT imaging for each patient, systematic lymphadenectomy with tailor-made vascular dissection by laparoscopy appears to be feasible and more meticulous compared to one by conventional open surgery.

Keywords: Laparoscopic surgery, 3D-CT navigation surgery, Tailor-made surgery.


仮想咬合器およびNC工作機を用いたクラウン作製システム
Development of Crown Production System by Virtual Articulator and NC Machine Tool

八木橋信a,藤本英雄a,陳 連怡a,坂口正道a, 伊藤 裕b, 杉山 茂b, 阿部俊之b
a 名古屋工業大学大学院 工学研究科
b 愛知学院大学 歯学部

Makoto Yagihashi a, Hideo Fujimoto a, Lian-yi Chen a, Masamichi Sakaguchi a, Yutaka Itoi b, Shigeru Sugiyama b, Toshiyuki Abe b
a Graduate School of Engineering, Nagoya Institute of Technology
b Department of Fixed Prosthodontics, School of Dentistry, Aichi-Gakuin University

Abstract: This paper introduces a dental crown production system. The crown designed in this system not only had no interference at intercuspal position but also given functional occlusal surfaces. The functional occlusal surface was created with virtual articulator which reproduces the movement of subject's mandible on a computer system. Finally, validity of the processes in this crown production system, errors which were caused in each process and the necessity of dental CAE(Computer-Aided Engineering) system were discussed.

Keywords: Virtual articulator, Functional occlusal surface, Dental crown, Mandibular movement.


歯の切削を実現した人工現実感歯科治療訓練システム
A Dental Training System with Tooth Cutting using Virtual Reality

陳 連怡a*,藤本英雄a,三輪光太郎a, 八木橋信a, 阿部俊之b, 墨 温子b, 伊藤 裕b
a 名古屋工業大学 工学部
b 愛知学院大学 歯学部

Lian-yi Chen a, Hideo Fujimoto a, Kotaro Miwa a, Makoto Yagihashi a, Toshiyuki Abe b, Atsuko Sumi b, Yutaka Ito b
a Department of Mechanical Engineering, Nagoya Institute of Technology
b Department of Fixed Prosthodontics, School of Dentistry, Aichi-Gakuin University

Abstract: There are several problems in conventional dental trainings using a mannequin due to the lack of reality.To solve such problems, we proposed in this study a dental training system using the virtual reality technology. In our system, a virtual environment and a virtual patient were produced in a virtual space, where the dental mirror and hand pieces can be operated real-timely. The force feedback of operations and a tooth cutting operation in training were realized using two computers. Furthermore, in order to be aware of and to avoid possible dangers, the tongue of the patient was moved randomly in training, and warnings with sound and a signal of blood were given when the drill contacts tongue or mucous membrane of mouth. Experiments of tooth cutting and operating were carried out with good training effects confirmed.

Keywords: Dental training, Virtual reality, Haptics, Force feedback, Awareness of danger.