Abstract: Goal: Purpose of the project was to make a plastic surgery prediction by using pre-operative images for the plastic surgeries’ patients and to show this prediction on a screen to compare between the current case and the appearance after the surgery. Methods: To this aim, we implemented a software which used data from the internet for facial skin diseases, skin burns, pre-and post-images for plastic surgeries then the post- surgical prediction is done by using K-nearest neighbor (KNN). So we designed and fabricated a smart mirror divided into two parts a screen and a reflective mirror so patient's pre- and post-appearance will be showed at the same time. Results: We worked on some skin diseases like vitiligo, skin burns and wrinkles. We classified the three degrees of burns using KNN classifier with accuracy 60%. We also succeeded in segmenting the area of vitiligo. Our future work will include working on more skin diseases, classify them and give a prediction for the look after the surgery. Also we will go deeper into facial deformities and plastic surgeries like nose reshaping and face slim down. Conclusion: Our project will give a prediction relates strongly to the real look after surgery and decrease different diagnoses among doctors. Significance: The mirror may have broad societal appeal as it will make the distance between patient's satisfaction and the medical standards smaller.
Abstract: Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.
Abstract: The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.
Abstract: This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.
Abstract: Many orthopedic implants like proximal humerus cases require lower surface roughness and almost immediate/short lead time surgery. Thus, rapid response from the manufacturer is very crucial. Tool path strategy of milling process has a direct influence on the surface roughness and lead time of medical implant. High-speed milling as promised process would improve the machined surface quality, but conventional or super-abrasive grinding still required which imposes some drawbacks such as additional costs and time. Currently, many CAD/CAM software offers some different tool path strategies to milling free form surfaces. Nevertheless, the users must identify how to choose the strategies according to cutting tool geometry, geometry complexity, and their effects on the machined surface. This study investigates the effect of different tool path strategies for milling a proximal humerus head during finishing operation on stainless steel 316L. Experiments have been performed using MAHO MH700 S vertical milling machine and four machining strategies, namely, spiral outward, spiral inward, and radial as well as zig-zag. In all cases, the obtained surfaces were analyzed in terms of roughness and dimension accuracy compared with those obtained by simulation. The findings provide evidence that surface roughness, dimensional accuracy, and machining time have been affected by the considered tool path strategy.
Abstract: This study aimed at developing an inverse heat transfer approach for predicting the time-varying freezing front and the temperature distribution of tumors during cryosurgery. Using a temperature probe pressed against the layer of tumor, the inverse approach is able to predict simultaneously the metabolic heat generation and the blood perfusion rate of the tumor. Once these parameters are predicted, the temperature-field and time-varying freezing fronts are determined with the direct model. The direct model rests on one-dimensional Pennes bioheat equation. The phase change problem is handled with the enthalpy method. The Levenberg-Marquardt Method (LMM) combined to the Broyden Method (BM) is used to solve the inverse model. The effect (a) of the thermal properties of the diseased tissues; (b) of the initial guesses for the unknown thermal properties; (c) of the data capture frequency; and (d) of the noise on the recorded temperatures is examined. It is shown that the proposed inverse approach remains accurate for all the cases investigated.
Abstract: Cardiovascular diseases are one of the most common causes of mortality in developed countries. Coronary artery abnormalities and carotid artery stenosis, also known as silent death, are among these diseases. One of the treatment methods for these diseases is to create a deviatory pathway to conduct blood into the heart through a bypass surgery. The saphenous vein is usually used in this surgery to create the deviatory pathway. Unfortunately, a re-surgery will be necessary after some years due to ignoring the disagreement of mechanical properties of graft tissue and/or applied prostheses with those of host tissue. The objective of the present study is to clarify the viscoelastic behavior of human saphenous tissue. The stress relaxation tests in circumferential and longitudinal direction were done in this vein by exerting 20% and 50% strains. Considering the stress relaxation curves obtained from stress relaxation tests and the coefficients of the standard solid model, it was demonstrated that the saphenous vein has a non-linear viscoelastic behavior. Thereafter, the fitting with Fung’s quasilinear viscoelastic (QLV) model was performed based on stress relaxation time curves. Finally, the coefficients of Fung’s QLV model, which models the behavior of saphenous tissue very well, were presented.
Abstract: In this paper, conventional laser Keratoplasty surgeries in the human eye are studied. For this purpose, a validated 3D finite volume model of the human eye is introduced. In this model the fluid flow has also been considered. The discretized domain of the human eye incorporates a bio-heat transfer equation coupled with a Boussinesq equation. Both continuous and pulsed lasers have been modeled and the results are compared. Moreover, two different conventional surgical positions that are upright and recumbent are compared for these laser therapies. The simulation results show that in these conventional surgeries, the temperature rises above the critical values at the laser insertion areas. However, due to the short duration and the localized nature, the potential damages are restricted to very small regions and can be ignored. The conclusion is that the present day lasers are acceptably safe to the human eye.
Abstract: Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery.
Abstract: Stiffness sensing is an important issue in medical diagnostic, robotics surgery, safe handling, and safe grasping of objects in production lines. Detecting and obtaining the characteristics in dwelling lumps embedded in a soft tissue and safe removing and handling of detected lumps is needed in surgery. Also in industry, grasping and handling an object without damaging in a place where it is not possible to access a human operator is very important. In this paper, a method for object handling is presented. It is based on the use of an intelligent gripper to detect the object stiffness and then setting a programmable force for grasping the object to move it. The main components of this system includes sensors (sensors for measuring force and displacement), electrical (electrical and electronic circuits, tactile data processing and force control system), mechanical (gripper mechanism and driving system for the gripper) and the display unit. The system uses a rotary potentiometer for measuring gripper displacement. A microcontroller using the feedback received by the load cell, mounted on the finger of the gripper, calculates the amount of stiffness, and then commands the gripper motor to apply a certain force on the object. Results of Experiments on some samples with different stiffness show that the gripper works successfully. The gripper can be used in haptic interfaces or robotic systems used for object handling.
Abstract: In this paper, the design and evaluation of a handle for laparoscopic surgery is presented. The design of the handle is based on ergonomic principles and tries to avoid awkward postures for surgeons. The handle combines the so-called power-grip and accurate-grip in order to provide strength and accuracy in the performance of surgery. The handle is tested using both objective and subjective approaches. The objective approach uses motion capture techniques to obtain the angles of forearm, arm, wrist and hand. The muscular effort is obtained with electromyography electrodes. On the other hand, a subjective survey has been carried out using questionnaires. Results confirm that the handle is preferred by the majority of the surgeons.
Abstract: A conventional optical coherence tomography (OCT) system has limited imaging depth, which is 1-2 mm, and suffers unwanted noise such as speckle noise. The motorized-stage-based OCT system, using a common-path Fourier-domain optical coherence tomography (CP-FD-OCT) configuration, provides enhanced imaging depth and less noise so that we can overcome these limitations. Using this OCT systems, OCT images were obtained from an onion, and their subsurface structure was observed. As a result, the images obtained using the developed motorized-stage-based system showed enhanced imaging depth than the conventional system, since it is real-time accurate depth tracking. Consequently, the developed CP-FD-OCT systems and algorithms have good potential for the further development of endoscopic OCT for microsurgery.
Abstract: Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.
Abstract: Growth and remodeling of biological structures have
gained lots of attention over the past decades. Determining the
response of living tissues to mechanical loads is necessary for a wide
range of developing fields such as prosthetics design or computerassisted
surgical interventions. It is a well-known fact that biological
structures are never stress-free, even when externally unloaded. The
exact origin of these residual stresses is not clear, but theoretically,
growth is one of the main sources. Extracting body organ’s shapes
from medical imaging does not produce any information regarding
the existing residual stresses in that organ. The simplest cause of such
stresses is gravity since an organ grows under its influence from
birth. Ignoring such residual stresses might cause erroneous results in
numerical simulations. Accounting for residual stresses due to tissue
growth can improve the accuracy of mechanical analysis results. This
paper presents an original computational framework based on gradual
growth to determine the residual stresses due to growth. To illustrate
the method, we apply it to a finite element model of a healthy human
face reconstructed from medical images. The distribution of residual
stress in facial tissues is computed, which can overcome the effect of
gravity and maintain tissues firmness. Our assumption is that tissue
wrinkles caused by aging could be a consequence of decreasing
residual stress and thus not counteracting gravity. Taking into
account these stresses seems therefore extremely important in
maxillofacial surgery. It would indeed help surgeons to estimate
tissues changes after surgery.
Abstract: Objective: Safety and efficacy of Ahmed glaucoma
valve implantation for the management of uveitis induced glaucoma
evaluated on the five dogs with uncontrollable glaucoma. Materials
and Methods: Ahmed Glaucoma Valve (AGV®; New World
Medical, Rancho Cucamonga, CA, USA) is a flow restrictive, nonobstructive
self-regulating valve system. Preoperative ocular
evaluation included direct ophthalmoscopy and measurement of the
intraocular pressure (IOP). The implant was examined and primed
prior to implantation. The selected site of the valve implantation was
the superior quadrant between the superior and lateral rectus muscles.
A fornix-based incision was made through the conjunectiva and
Tenon’s capsule. A pocket is formed by blunt dissection of Tenon’s
capsule from the episclera. The body of the implant was inserted into
the pocket with the leading edge of the device around 8-10 mm from
the limbus. Results: No post-operative complications were detected
in the operated eyes except a persistent corneal edema occupied the
upper half of the cornea in one case. Hyphaema was very mild and
seen only in two cases which resolved quickly two days after surgery.
Endoscopical evaluation for the operated eyes revealed a normal
ocular fundus with clearly visible optic papilla, tapetum and retinal
blood vessels. No evidence of hemorrhage, infection, adhesions or
retinal abnormalities was detected. Conclusion: Ahmed glaucoma
valve is safe and effective implant for treatment of uveitic glaucoma
in dogs.
Abstract: Excessive fretting wear at the taper-trunnion junction
(trunnionosis) apparently contributes to the high failure rates of hip
implants. Implant wear and corrosion lead to the release of metal
particulate debris and subsequent release of metal ions at the tapertrunnion
surface. This results in a type of metal poisoning referred to
as metallosis. The consequences of metal poisoning include;
osteolysis (bone loss), osteoarthritis (pain), aseptic loosening of the
prosthesis and revision surgery. Follow up after revision surgery,
metal debris particles are commonly found in numerous locations. Background: A stable connection between the femoral ball head
(taper) and stem (trunnion) is necessary to prevent relative motions
and corrosion at the taper junction. Hence, the importance of
component assembly cannot be over-emphasized. Therefore, the aim
of this study is to determine the influence of head-stem junction
assembly by press fitting and the subsequent
disengagement/disassembly on the connection strength between the
taper ball head and stem. Methods: CoCr femoral heads were assembled with High stainless
hydrogen steel stem (trunnion) by Push-in i.e. press fit; and
disengaged by pull-out test. The strength and stability of the two
connections were evaluated by measuring the head pull-out forces
according to ISO 7206-10 standards. Findings: The head-stem junction strength linearly increases with
assembly forces.
Abstract: Total hip replacement had been one of the most
successful operations in hip arthritis surgery. The purpose of this
research had been to develop a dynamic hip contact of Thai femoral
bone to analyze the stress distribution on the implant and the strain
distribution on the bone model under daily activities and compared
with the static load simulation. The results showed the different of
maximum von Mises stress 0.14 percent under walking and 0.03
percent under climbing stair condition and the different of equivalent
total strain 0.52 percent under walking and 0.05 percent under
climbing stair condition. The muscular forces should be evaluated
with dynamic condition to reduce the maximum von Mises stress and
equivalent total strain.
Abstract: Human face has a fundamental role in the appearance
of individuals. So the importance of facial surgeries is undeniable.
Thus, there is a need for the appropriate and accurate facial skin
segmentation in order to extract different features. Since Fuzzy CMeans
(FCM) clustering algorithm doesn’t work appropriately for
noisy images and outliers, in this paper we exploit Possibilistic CMeans
(PCM) algorithm in order to segment the facial skin. For this
purpose, first, we convert facial images from RGB to YCbCr color
space. To evaluate performance of the proposed algorithm, the
database of Sahand University of Technology, Tabriz, Iran was used.
In order to have a better understanding from the proposed algorithm;
FCM and Expectation-Maximization (EM) algorithms are also used
for facial skin segmentation. The proposed method shows better
results than the other segmentation methods. Results include
misclassification error (0.032) and the region’s area error (0.045) for
the proposed algorithm.
Abstract: In this study, a comparison of two control methods,
Proportional Control (PC) and Fuzzy Logic Control (FLC), which
have been used to develop an ideal thermoelectric renal hypothermia
system in order to use in renal surgery, has been carried out. Since
the most important issues in long-lasting parenchymatous renal
surgery are to provide an operation medium free of blood and to
prevent renal dysfunction in the postoperative period, control of the
temperature has become very important in renal surgery. The final
product is seriously affected from the changes in temperature,
therefore, it is necessary to reach some desired temperature points
quickly and avoid large overshoot. PIC16F877 microcontroller has
been used as controller for both of these two methods. Each control
method can simply ensure extra renal hypothermia in the targeted
way. But investigation of advantages and disadvantages of every
control method to each other is aimed and carried out by the
experimental implementations. Shortly, investigation of the most
appropriate method to use for development of system and that can be
applied to people safely in the future, has been performed. In this
sense, experimental results show that fuzzy logic control gives out
more reliable responses and efficient performance.
Abstract: Determining depth of anesthesia is a challenging problem
in the context of biomedical signal processing. Various methods
have been suggested to determine a quantitative index as depth of
anesthesia, but most of these methods suffer from high sensitivity
during the surgery. A novel method based on energy scattering of
samples in the wavelet domain is suggested to represent the basic
content of electroencephalogram (EEG) signal. In this method, first
EEG signal is decomposed into different sub-bands, then samples
are squared and energy of samples sequence is constructed through
each scale and time, which is normalized and finally entropy of the
resulted sequences is suggested as a reliable index. Empirical Results
showed that applying the proposed method to the EEG signals can
classify the awake, moderate and deep anesthesia states similar to
BIS.