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Biomedical subjects

Asaki Hattori

Publications and source records attributed to Asaki Hattori.

At least 19 recordsLinked to original sources

Robotic surgery setup simulation with the integration of inverse-kinematics computation and medical imaging.

At present, there are representative robot operation systems such as da Vinci and ZEUS which have realized minimally invasive surgery by the use of dexterous manipulators. In the operating room, medical staff must prepare and set up an environment in which the robot has optimal freedom of motion and its functions can be fully demonstrated for every case. The range of motion in which the robot can reach and be maneuvered is restricted by the fixed point of the trocar site. We have developed a preoperative planning system with the function of volume rendering of medical images and automatic positioning by applying an inverse-kinematics computation of surgical robot. The motion of a surgical robot can be simulated in advance with the intuitive interface and kinematics computation program running in the background of the system. If robotic surgery planning with volume rendering of DICOM images is possible, the discussion of a surgical plan can be directly made just after the diagnosis considering the patient-specific structure. This kind of setup platform would be essential for the future introduction of surgical robotics into an operating room.

Algorithms↗

Surgical navigation display system using volume rendering of intraoperatively scanned CT images.

As operative procedures become more complicated, simply increasing the number of devices will not facilitate such operations. It is necessary to consider the ergonomics of the operating environment, especially with regard to the provision of navigation data, the prevention of technical difficulties, and the comfort of the operating room staff. We have designed and created a data-fusion interface that enables volumetric Maximum Intensity Projection (MIP) image navigation using intra-operative mobile 3D-CT data in the OR. The 3D volumetric data reflecting a patient's inner structure is directly displayed on the monitor through video images of the surgical field using a 3D optical tracking system, a ceiling-mounted articulating monitor, and a small-size video camera mounted at the back of the monitor. The system performance and accuracy was validated experimentally. This system provides a novel interface for a surgeon with volume rendering of intra-operatively scanned CT images, as opposed to preoperative images.

Computer Graphics↗

Soft-tissue balance evaluation system for total hip arthroplasty by intraoperative contact pressure measurement at the hip joint.

We developed a system for measurement of contact pressure at the hip joint surfaces that enables checking of the artificial hip joint condition during surgery. First, we constructed the pressure sensor that forms the artificial joint. We installed eight small pressure sensors to the spherical head component, a part of the ball-socket joint. Next, we developed software for recording and visualizing the detected pressures that were recorded every 1 ms. The pressure distribution was displayed with the 3D computer graphics in real-time. The system enabled intuitive recognition of pressure direction 3-dimensions. Next, using the system, we conducted measurements during total hip arthroplasty. Although it requires some improvements in its measurement accuracy, the system allows real-time acquisition of information on the artificial hip joint in real-time. Further improvements of the calibration method should enable more accurate measurements. As a complete system, it will be a useful tool for selecting an appropriate implant that fits a patient's hip joint or for estimating the risk of complications after surgery.

Arthroplasty, Replacement, Hip↗

Estimation of skeletal movement of human locomotion from body surface shapes using dynamic spatial video camera (DSVC) and 4D human model.

We have been developing a DSVC (Dynamic Spatial Video Camera) system to measure and observe human locomotion quantitatively and freely. A 4D (four-dimensional) human model with detailed skeletal structure, joint, muscle, and motor functionality has been built. The purpose of our research was to estimate skeletal movements from body surface shapes using DSVC and the 4D human model. For this purpose, we constructed a body surface model of a subject and resized the standard 4D human model to match with geometrical features of the subject's body surface model. Software that integrates the DSVC system and the 4D human model, and allows dynamic skeletal state analysis from body surface movement data was also developed. We practically applied the developed system in dynamic skeletal state analysis of a lower limb in motion and were able to visualize the motion using geometrically resized standard 4D human model.

Biomechanical Phenomena↗

Data-fusion display system with volume rendering of intraoperatively scanned CT images.

In this study we have designed and created a data-fusion display that has enabled volumetric MIP image navigation using intraoperative C-arm CT data in the operating room. The 3D volumetric data reflecting a patient's inner structure is directly displayed on the monitor through video images of the surgical field using a 3D optical tracking system, a ceiling-mounted articulating monitor, and a small size video camera mounted at the back of the monitor. The system performance was validated in an experiment carried out in the operating room.

Computer Graphics↗

Gait analysis system for assessment of dynamic loading axis of the knee.

The purpose of this study was (1) to demonstrate a computer-assisted gait analysis system that can visualize the locus of the dynamic loading axis on the proximal tibia joint surface, and (2) to assess the accuracy of this system in a patient with bilateral knee osteoarthritis (OA). This system uses force plate data, CT skeletal structure data and motion capture data obtained from an infrared position sensor. The relative positions between bones and markers were used to calculate skeletal model movement based on movement of the markers. The locus of the dynamic loading axis on the knee joint was defined as the point on the proximal tibia joint surface that intersected with the loading axis of the lower limb, which passed through the centre of the femoral head and the centroid of multiple points surrounded by the distal tibia joint surface contour. To assess the accuracy of this system, open MRI was used to evaluate positions of skin markers against bones in six healthy volunteers. The locus in a patient was affected by differences between the varus knee with medial compartment OA on the non-operative side and the knee treated with high tibial osteotomy (HTO) on the opposite side. At knee flexion angles of 0 degrees, 15 degrees and 30 degrees, the mean value of measurement error for point locations on the locus was within 5.6% of joint width in the lateral direction (JWLD) on the proximal tibia joint. This system can provide clinically useful information for evaluation of the dynamic loading axis on the knee joint surface.

Aged↗

Change in the locus of dynamic loading axis on the knee joint after high tibial osteotomy.

The purpose of this study was to visualise the locus of the dynamic loading axis on the knee joint, and to evaluate changes in this locus during gait after high tibial osteotomy (HTO) in three patients who underwent HTO for medial compartment osteoarthritis (OA) of a varus knee. The bone structure of the lower limb and the relative position of skin markers were acquired from CT images. Motion capture data was acquired using spherical skin markers. Skeletal model movement during gait was calculated based on the movement of the markers. The locus of the dynamic loading axis on the knee joint was defined as the point on the proximal tibia joint surface that intersected with the loading axis of the lower limb, which passed through the centre of the femoral head and the centroid of multiple points surrounded by the distal tibia joint surface contour. This system was able to visualise the locus of the dynamic loading axis on the knee joint and not only lateral but also anterior-posterior direction movement. After HTO, the locus shifted from a medial and posterior area of the medial joint edge of the knee to a central area of the knee joint surface. This indicates that HTO shifted the dynamic loading axis. Lateral movement of the dynamic loading axis in the early stance phase of gait was reduced within a year after HTO.

Aged↗

Surgical robot setup simulation with consistent kinematics and haptics for abdominal surgery.

Preoperative simulation and planning of surgical robot setup should accompany advanced robotic surgery if their advantages are to be further pursued. Feedback from the planning system will plays an essential role in computer-aided robotic surgery in addition to preoperative detailed geometric information from patient CT/MRI images. Surgical robot setup simulation systems for appropriate trocar site placement have been developed especially for abdominal surgery. The motion of the surgical robot can be simulated and rehearsed with kinematic constraints at the trocar site, and the inverse-kinematics of the robot. Results from simulation using clinical patient data verify the effectiveness of the proposed system.

Biomechanical Phenomena↗

Development of a navigation function for an endosocopic robot surgery system.

An endoscopic robot system that we reported at MMVR11 is able to perform various surgical procedures in the stomach by using two manipulators. However, it is difficult for surgeons to recognize the 3D location and the direction of the endoscope's tip in the abdominal region during robotic surgery. In this research, we have developed a navigation function that enables image-guided surgery by superimposing the patient's abdominal organ structure onto the endoscopic image. In this paper, we describe the overview of the navigation for the robot system and the result of an animal experiment done while applying the system.

Endoscopy↗

Development of a 3D visualization system for surgical field deformation with geometric pattern projection.

Intra-operative navigation in which the target position is provided to assist an intuitive understanding of the surgical field has been studied and applied in many clinical areas. Position measurement of a surgical field is usually performed with a magnetic sensor, a marker type optical position sensor. For navigation of hard tissue, the measurement of several markers dispersedly located on the surface is enough to detect the position of an object that can be assumed as a rigid body. However, for the navigation of soft tissue such as skin and liver, a sensor that can measure the deformation of the object surface time-sequentially would be essential. We have developed a 3D visualization system for surgical field deformation with geometric pattern projection. In an animal experiment, the registration of preoperative 3D organ model could be done with the time-sequentially updated surface deformation data. In the video image of surgical field, the inner structure model of organ could be superimposed successfully.

Elasticity↗

Estimation of dislocation after total hip arthroplasty by 4-dimensional.

We constructed a 4-dimensional musculoskeletal model for patients who have undergone total hip arthroplasty (THA), which aimed to simulate the movement of the patient's inner body structure and estimate the complications that can arise with THA. The model reflects patient-specific characteristics of the bone geometry, implant alignment and hip movement. In order to estimate the direction of the muscle force and the length of the muscles, we developed a string-type muscle model that represents the route of the muscles. The strings expand and contract according to the movement of the origin and insertion location of the muscle. We developed models for the seven muscles related to movement of the hip joint. By using this model, clinicians will be able to predict the possibility of dislocation or recognize the actual causes of dislocation, as well as any possible influences the muscle may have on dislocation.

Arthroplasty, Replacement, Hip↗

Analysis of masticatory muscle condition using the 4-dimensional muscle model for a patient with square mandible.

The present study was conducted to ascertain characteristics of mandibular movements in patients with SQM, observe the kinetics of masticatory muscles using a four-dimensional (4D) muscle model, and kinetically investigate the etiology of Square Mandible (SQM). As results, 1, In the maximum opening position, location of the condyle was beyond the articular tubercle for volunteer, but within the mandibular fossa for SQM patient. 2, While the temporal muscle of volunteer was markedly expanded, that of SQM patient was not. 3, In both volunteer and SQM during left lateral excursion, the right mandibular condyle moved to a position slightly before the lowest point of the articular tubercle. The 4D muscle model showed that the cause of limited mouth opening in SQM patient was insufficient expansion of the temporal muscle, and not dysfunction of the opening muscles. Insufficient expansion of the temporal muscle stresses the masseter muscle and leads to hypertrophy of the masseter muscle and hyperplasia of the mandibular angle, resulting in the unique facial configuration.

Adult↗

Construction of a high-tech operating room for image-guided surgery using VR.

This project aimed to construct an operating room to implement high dimensional (3D, 4D) medical imaging and medical virtual reality techniques that would enable clinical tests for new surgical procedures. We designed and constructed such an operating room at Dai-san Hospital, the Jikei Univ. School of Medicine, Tokyo, Japan. The room was equipped with various facilities for image-guided, robot and tele- surgery. In this report, we describe an outline of our "high-tech operating room" and future plans.

Facility Design and Construction↗

Tele-surgical simulation system for training in the use of da Vinci surgery.

Laparoscopic surgery including robotic surgery allows the surgeon to be able to conduct minimally invasive surgery. A surgeon is required to master difficult skills for this surgery to compensate for the narrow field of view, limitation of work space, and the lack of depth sensation. To counteract these drawbacks, we have been developing a training simulation system that can allow surgeons to practice and master surgical procedures. In addition, our system aims to distribute a simulation program, to provide a means of collaboration between remote hospitals, and to be able to provide a means for guidance from an expert surgeon. In this paper, we would like to show the surgery simulation for da Vinci surgery, in particular a cholecystectomy. The integral parts of this system are a soft tissue model which is created by the sphere-filled method enabling real-time deformations based on a patient's data, force feedback devices known as a PHANToM and the Internet connection. By using this system a surgeon can perform surgical maneuvers such as pushing, grasping, and detachment in real-time manipulation. Moreover, using the broadband communication, we can perform the tele-surgical simulation for training.

Computer Simulation↗

Four-dimensional model of the lower extremity after total hip arthroplasty.

We have developed a four-dimensional (4D) model of the lower extremities after total hip arthroplasty in patients. The model can aid in preventing complications such as dislocation and wearing of the sliding surface. The skeletal structure and implant alignment were obtained from CT data. We applied registration method using CAD data to estimate accurate implant alignment from scattered CT data. The reconstructed three-dimensional (3D) skeletal model was combined with motion capture data that were acquired by an optical tracking system. We displayed the patient's skeletal movement and analyzed several parameters that relate to complications. The patient's skeletal model was superimposed onto video footage that was taken by a synchronized and calibrated digital video camera. For validation of the measurement error in this system, we used open MRI to evaluate the relative movement between skin markers and bones. This system visually represents not only the 3D anatomical structure, but also 4D dynamic functions that include the time sequential transitions of components and their positions. The open MRI results indicated that the average error in hip angle was within 5 degrees for each static posture. This system enables clinicians to analyze patient's motions on the basis of individual differences. We found that our system was an effective tool in providing precise guidance of daily postoperative motions that was individualized for each patient. This system will be applicable for surgical planning, assessment of postoperative activities, and the development of new surgical techniques, materials, and prosthetic designs.

Adolescent↗

A novel system of four-dimensional motion analysis after total hip arthroplasty.

We have developed a novel system of four-dimensional motion analysis after total hip arthroplasty (THA) that can aid in preventing dislocation by assessing safe range of motion for patients in several daily activities. This system uses skeletal structure data from CT and motion capture data from an infrared position sensor. A 3-D model reconstructed from CT data is combined with the motion capture data. Using this system, we analyzed hip motion when getting up from and sitting down in a chair or picking up an object while sitting in a chair in 17 patients (26 hips) who underwent THA. To assess the accuracy of this system's measurements, open MRI was used to evaluate positions of skin markers against bones in five healthy volunteers in various postures. No impingement between bones and/or implants was found in any subjects during any activities. However, mean angle at the point of maximum hip flexion was different for each patient. The open MRI results indicated that average error in hip angle of the present system was within 5 degrees for each static posture. The functional position of the pelvis during daily activities must be taken into account when assessing the real risk of dislocation. The present system enables dynamic analysis involving not only alignment of components and bones of each patient, but also individual differences in characteristics of daily motions. Further investigation using this system can help determine safe ranges of motion for preventing hip dislocation, improving the accuracy of individualized guidance for patients regarding postoperative activities.

Adolescent↗

Effects of rotation on measurement of lower limb alignment for knee osteotomy.

The purposes of this study were to clarify the effects of rotation on two-dimensional measurement of lower limb alignment for knee osteotomy using a three-dimensional method and to determine whether this 3-D simulation method could help with planning of knee osteotomy. We developed computer software to calculate femorotibial angle (FTA) and hip-knee-ankle angle (HKA) and simulate knee osteotomy from a CT-based 3-D bone model of the lower limb. Lower limb rotation on anteroposterior long-standing radiographs was measured by superimposing the 3-D bone models. Changes in alignment with limb rotation were calculated using the software. FTA after virtual closed-wedged osteotomy was measured for a hypothetical case of a rotation error of the osteotomy plane in reattaching the proximal cutting surface to the distal cutting surface. For 31 varus knees in 20 patients with medial compartment arthritis, the mean rotation angle, relative to the epicondylar axis, with variable limb position was 7.4 +/- 3.9 degrees of internal rotation (mean +/- SD), ranging from 8 degrees of external rotation to 14 degrees of internal rotation; the mean changes in FTA and HKA were 3.5 +/- 2.2 degrees (range, 0.4-8.6) and 1.6 +/- 1.3 degrees (range, 0.2-4.9), respectively. The FTA "flexion angle" (lateral view alignment from neutral AP) and the absolute HKA "flexion angle" correlated with the change in FTA and HKA with limb rotation, respectively (FTA, R = 0.999; HKA, R = 0.993). The mean change in FTA after virtual closed-wedged osteotomy was 3.2 degrees for internal and external 10 degrees rotation errors in reattaching the osteotomy plane. Rotation may affect measurement of lower limb alignment for knee osteotomy, and 3-D methods are preferable for surgical planning.

Adult↗