Computational challenges in the operating room: A study of transurethral imaging and technologies

Over the past 20 years, there have been radical changes to the surgical treatment of disease. New approaches can eradicate disease and spare viable tissue. The primary premise of these new approaches is to use small incisions and complex instrumentation. As a result, the field of minimally invasive and robotic surgery now dominates several medical disciplines. Instead of cracked bones and large incisions, patients are walking away from surgery with 1-inch scars and shorter recoveries. These new procedures are helping to reduce the healthcare burden of patients and societies. With such a dramatic change in operating room procedures, surgeons and interventionalists are faced with a challenge: providing the same level of service with fewer resources. During a procedure, the surgeons frame of reference is now limited. Instead of viewing the entire organ of interest, the surgeon is afforded only a limited view either from an endoscopic camera or an x-ray fluoroscope. Rather than a large open cavity, the surgeon is left with a small area to work in. To overcome the challenges of minimally invasive procedures, surgeons are now relying heavily on technology to enhance the surgical experience. Imaging is a crucial technology as it provides detailed information about the patient’s body-both healthy and diseased. Moreover, when properly integrated into a procedure, imaging can provide real-time feedback about the therapy. The use of technology-imaging and otherwise-requires adequate computational resources to process, analyze, and visualize the data. This talk presents a review of the basics of minimally invasive image-guided procedures, providing several specific examples of technology in the Operating Room. I highlight where computational tools have worked-and where they have not. For example, the use of transurethral ultrasound will likely change the way prostate disease is treated, but only if it is correctly married to the right computational tools. Finally, I look at the computational needs for future procedures.