The surgical CAD/CAM paradigm and an implementation for robotically-assisted percutaneous local therapy

Abstract

Computer-integrated surgery represents a growing segment of our national healthcare system. These systems transform preoperative images and other information into models of individual patients, assist clinicians in developing an optimized interventional plan, register this preoperative data to the actual patient in the operating room, and then use a variety of means, such as robots and image overlay displays, to assist in the accurate execution of the planned interventions. Finally, they perform complex postoperative analysis of the interventions. Borrowing analogies from industrial production systems, the process was named surgical CAD/CAM. Percutaneous ("through skin") local therapies represent a significant portion of minimally invasive procedures. They involve the insertion of tubular therapy devices (needles, catheters, bone drills, screws, tissue ablating devices, etc.) into the body, with the guidance of intra-operative imaging devices, like CT, MRI, ultrasound, or fluoroscopy. Percutaneous systems also depend on sophisticated image acquisition and analysis tools. This paper provides an introduction to the surgical CADICAM paradigm and also presents an implementation of the paradigm for percutaneous local therapies.