Digital Health Driven Therapy Systems
ACMIT is putting main emphasis on the development of new technology for minimally and micro-invasive procedures with increased consideration of surgical data aspects with the slogan “Digital Health Driven Therapy Systems“.
From technical and “procedural” viewpoint, research and development in ACMIT is covering the entire chain of activities – starting from advanced planning of the therapy, over the delivery of therapy by smart tools (e.g. with in-situ monitoring of therapy, advanced control of the therapy process) and guidance of such tools (e.g. by means of medical robotic systems or navigation technology), up to aspects related to the operator site (e.g. work-flow support) and even beyond (e.g. establishing of a surgical knowledge base for a more global advancement of surgical procedures). To complete the chain of translational research and development, work in ACMIT also includes evaluation of such new technology in realistic clinical setups which also addresses the increased requirements from the EU Medical Device Regulation (MDR). ACMIT research and development activities are structured into three research areas. The research scope has been mapped onto a “Sense – Plan – Act” structure.
Autonomy in Surgery
This research area is dealing with tools and methods for delivery of treatment, i.e. for the transfer of planned action into action – also including methods for adaptation of planned actions based on situation awareness. In the deliberative control scheme of a therapy process, this area is covering the “acting” phase.
Research tasks of topic “Smart Tools and Instruments” address some of the key points for improvement of state of the art MIS procedures. Based on the existing concept for steerable stylets and trocars, tools will be developed for concrete applications and tested clinically. Tool design activities also will be related to integration of the sensors developed in research area Sensor Systems for Diagnosis and Therapy into surgical tools for real-time in vivo therapy monitoring. Finally, investigation of new surgical access systems will complete the range of activities regarding “smart tools”. Furthermore, new application setups for our existing robot technology will be investigated as well as concepts for Cognitive Surgical Systems. For the latter topic, especially aspects of autonomous task execution as well as collaborative human/robot setups will be analysed in terms of concrete clinical use cases.
Tasks of topic “Information-based Therapy” aim to investigate concepts for data-based treatment. New methods for surgical navigation will be developed, including efficient and accurate registration, soft tissue navigation, and navigation based on real-time imaging. Furthermore, we address treatment optimization based on sensor data in a local context, as well as globally by investigation of methods related to “Surgical IoT” and “Surgical Data Science”.
Sensor Systems for Diagnosis and Therapy
This research area is mainly dealing with the development of novel sensor technology for therapy monitoring and thus covers the “sensing” phase in the deliberative control scheme of a therapy process.
This research area is addressing the topics “Advanced Sensor Systems” and “Improving Quality of Vision”.
“Advanced Sensor Systems” essentially aim to provide intra-operative surgeon feedback by system/instrument integrated sensor components. Giving surgeons a real-time feedback about the actually treated tissue can significantly improve the intervention or directly provide diagnostic results. Planned activities include in particular the development of miniaturized sensor components for integration in instruments for minimal invasive surgery, for example for needle based sensorized tools. Together with sensor data acquisition and signal analysis these topics constitute the main research activities. Another part of activities is related to sensorized systems and tools which are not directly involved in surgical interventions. These tasks activities for point of care applications which are settled in the fields of prevention and home care monitoring. Their goal is to provide patient individual data for diagnosis and therapy related decision-making.
Based on our optic design know-how in combination with simulations tools, the topic “Improving Quality of Vision“ deals with development of optical elements under the umbrella of the term “Quality of Vision”. Main focus of activities is in ophthalmology, especially including optic design concepts for intraocular lenses (IOLs) in combination with methods and tools for assessment of the subjective vision quality and patient satisfaction. Multifocal as well as extended depth of focus IOLs not only allow to satisfy individual preferences in cataract surgery, but also entail the need for increased patient guidance, which has to be supported by appropriate tools during the clinical workflow practice. Therefore, lens design for capsular bag IOLs as well as supplementary lens platforms and the development of an IOL selection support system belong to the main research tasks. Besides these activities in ophthalmology, we work on optical setups and components which are not directly dedicated to a sensory functionality, such as improvement of the surgeon’s limited view in endoscopic applications.
Therapy Planning and Workflow Support
This research area is dealing with new methods for planning of treatment in the pre-operative phase as well as with different aspects of workflow support in order to help the surgeon to sufficiently adhere to such a plan. In the deliberative control scheme of a therapy process, this area thus is covering the “planning” phase.
The topic “Therapy Workflow Support” is dealing with different aspects of workflow support, starting with an update of our current workflow assessment system, development of a generic workflow modelling toolbox, and implementation of a workflow engine in 3D Slicer. One core activity is generation of process specific process models and their use for workflow monitoring and workflow support systems. The aforementioned modules will be integrated to demonstrators in different configurations and for different clinical use cases.
The topic “Advanced Planning Concepts” basically deals with two different approaches for pre-operative planning. Investigation of software tools for planning in particular spotlights the integration of simulation methods into the planning procedure for immediate estimation of the effect of treatment and iterative improvement of the plan. In addition, the potential use of pre-existing data/knowledge for optimal planning will be investigated. Furthermore, different aspects and options of the use of Additive Manufacturing for pre-operative planning will be analyzed in detail – including the application of this planning method in selected use cases.