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medical instruments A obligatory assignment 1
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- Technische Universiteit Delft (TU Delft)
medical instruments A obligatory assignment 1 answers
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BM41095Assignment 1
Question 1
1a)
Figure 1:Block diagram of minimally Figure 2:Block diagram of hand-assisted
invasive surgery Figure 4 laparoscopic surgery Figure 6
Figure 3:Block diagram of minimally
invasive surgery in the near future Figure 11
In figure 1, the surgeon is using a laparoscopic instrument to treat the patient because of the
poor ergonomic design and lack of tactile sensation, the surgeon is receiving reduced
perceptive information compared to open surgery. Additionally, 3D information from the
patient is not available because of the flat 2D visual information which is collected from the
camera device in laparoscopy. Also, the 2D visual information that the surgeon obtains from
the screen presents in a different point of view from his hands and eyes. Furthermore, a third
person ‘assistant’ is included in the procedure to help with the laparoscopic device orientation
and this makes the system more complex as well as less efficient.
1
, In figure 2, the surgeon using a laparoscopic device as well as his hand from and incision.
This way, the tactile sensation of the surgeon is increasing while there is still reduced
perceptive information obtaining from the laparoscope. When it is compared with figure 1,
there is still 2D visual information obtaining from a screen that is presenting on a different
point of view than the eyes and hands of the surgeon. Additionally, the assistant is still
involved in adjusting the laparoscopic device the same as figure 1. The only difference in
figure 2 compared to figure 1 is, there is an increase in tactile sensation and manipulation of
tissue. However, this is something increasing the recovery time and complication risk of the
patient during surgery.
In figure 3, we can see the minimally invasive surgery shortly which there is no need for an
assistant anymore. This means there are less confusion and more movement area for the
surgeon. Furthermore, the surgeon can control the device himself by using hand movements
and an assistive device. Also, it appears that he is now able to get direct feedback from the
laparoscopic device without any attenuation. Another important development here is that the
2D image obtained from a laparoscopic camera is converted into 3D integrated information
by using a surgeon support system. In the end, the surgeon can get feedback from
laparoscopic devices and image as well as the patient.
There are a couple of important main changes in figure 3 that provides some advantages to
the surgeon when it is compared with figure 1 and 2. First of all, in figure 3 there is no more
attenuation on the feedback obtained from laparoscopic instruments and there is additional
feedback obtained from the patient compared with the other 2 figures. Moreover, there is no
need for an assistant to help with the laparoscopic devices which help the surgeon to have
more room for himself/herself and have less confusion compared with the 2 different
methods. Also, one of the main changes from Figures 1 and 2 to figure 3 is that now the
surgeon is dealing with the 3D image which is much more helpful for the perception of the
anatomic place. Last but not least, in figure 2, the surgeon can manipulate the tissue with his
hand and get some kind of tactile feedback but there is no hand manipulation in figure 3.
However, the surgeon is still able to get some feedback from both patient and the
laparoscopic device without attenuation.
1b)
First of all, some of the main issues that are being examined in the paper are the lack of
tactile feedback, 2D image obtained from the laparoscopic cameras that were controlled by
assistants, and the hand-eye movement issue. In the paper, it mentions that 2D images can be
converted into 3D images and the camera can be used with the head movement of the surgeon
in the future as well as improved possible future haptic feedback. There are laparoscopes with
a 3D display, improved tactile feedback, and higher depth perception which makes the
surgery more acceptable, safer, and cost-effective.10 Therefore, 3D display, the hand-eye
coordination of the surgeon is not a relevant issue anymore. However, we can say that the
control of the laparoscopic device with head movement or in a different way still needs to be
resolved.
2
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