Image Guided Surgeries - From Bench to Bedside and Back

Summer term 2015

About the real world Image Guided Surgery course:

Participants learn the basics of medical applications in minimally invasive image guided surgery and interventions. They gain the knowledge to understand the complex medical environment as well as its challenges in order to improve these procedures with the focus on clinical workflow and imaging in the operating theatre of the future. With knowledge about imaging technology and image processing algorithms participants will be able to model and master complex solutions. Besides the medical and technical knowledge, definition of clinical, technical projects in the field of intra operative imaging and navigation for minimal invasive surgery is the core focus during the course. Exposure to real world problems, observing an intervention at our clinical partner sites makes this a unique setup for modeling and implementing creative solutions to improve the care.

A new type of real world educational course participants will:

• learn the basics of some intraoperative and minimal-invasive surgeries explained in application examples and case reports/videos
• work in teams
• participate in an real surgery, document and analyze the procedure – from OR planning through patient anesthesia all the way to the finish
• directly communicate to the surgeons about the procedure
• develop a concept / solution to support procedures including interfaces, logistical approaches, use of technologies
• work in your teams analyzing these processes and come-up with possible improvements (use of diagnostic imaging, logistical improvements, ...)
• try to translate that into an actual proposal for the surgical team
• make two presentation to the class
• on the procedure itself
• final presentation including a proposal for a solution for the surgical teams

• IGS Lecture Overview:
  

Assignments

There are assignements as preperation for every lecture block:

• Assignment 1 (before lecture block 1):
  • Compulsory Reading: How Surgeons and Engineers Can Communicate Better
  • Compulsory Reading: A. Wolbarst and W. Hendee, Evolving and experimental technologies in medical imaging, Radiology, 238 (2006), pp. 16-39
  • Compulsory Reading: Ziv Yaniv and Kevin Cleary, “Image-Guided Procedures: A Review,” Georgetown University, CAIMR TR-2006-3, Apr. 2006. or equivalent knowledge through the CAMP 1 lecture

• Assignment 2 (send via 2 days before lecture block 2 / presented during lecture block 3):
  • Analysis of your OR visit application domain in form of a 10min presentation (details will be provided in the lecture block 1)

• Assignment 3 (2 days before lecture block 3):
  • Evaluation and classification and usage of medical imaging (details will be provided in the lecture block 2)

• Midterm presentation (Powerpoint or equivalent): duration 15 minutes including the medical basics of the procedure, equipment used, evaluation of procedure (logistics, use of equipment, timing, who is involved and individual roles, other relevant information, pain gain analysis, and next steps ...)
• Final Presentation (Powerpoint or equivalent): duration 15 minutes with your application domain introduction, engineering and computer science relevant evaluation, identification of process improvement, actual process improvement (pick one topic) e.g. with diagnostic imaging (improve quality and surgical accuracy? improve timing of procedure? forensic information? cost improvement?) and presentation of a concept, idea or prototype for improvement
• Concept Paper: prepare a 10-15 page document on the findings, if possible create a prototype or concept of a solution that supports your observed procedure
  

Administrative Info Lecture: Dr. Jörg Traub and Prof. Dr. Michael Friebe Tutor: Philipp Matthies Type: Lecture + Lab Courses (Module IN2286) Programs: Informatics (Bachelor, Master) Biomedical Computing (Master) Information Systems (Wirtschaftsinformatik) (Bachelor, Master) SWS: 2+2 ECTS: 6 Credits Course Language: English

Time, Location & Requirements Lecture: The lecture will be held in 4 blocks of six hours each (9:00am to 12:00am and 1:00pm to 4:00pm), the dates are: Block 1: April 17, 2015 (TUM-IAS conference room 0) Block 2: May 22, 2015 (TUM-IAS conference room 0) Block 3: June 19, 2015 (TUM-IAS conference room 0) Block 4: July 17, 2015 (3-day Seminar Trip to a Mountain Hut, probably 16.-18.07.2015) Locations: Conference room in IAS basement and MI 03.13.010 We will have teams working on NOTES procedures, conventional laparoscopy / bronchoscopy, arthroscopy, stenting interventions, and possibly other. The surgeries will be performed in Munich hospitals. The teams will be asked to contact the head surgeons for an appointment and arrange for a Q&A session before and/or after the surgery. The surgery should be well documented -- please use an engineering approach to analyze the procedures. Please note that the lecturers will be available 30 minutes prior to and 1 hour after the lecture in their office in the TUM-IAS building (Room 2.004), 2nd floor, right, last one on the left. Requirements: The classes and assignments are in English Assignments are to be composed in English only

Announcements Registration is closed. In case your need this course urgently send an application to Dr. Jörg Traub. Course is limited to 15 participants. Priority was given by time of registration. Grading will be based on attendance and active participation (10%), assignments (10%), the midterm presentation (10%), the final group presentation (15%), the proposal document and project work (35%), and a written test (45 minutes) on the technology basics (20%) One excused (E-Mail at least two days prior to lecture Dr. Jörg Traub with reason) absence will be accepted, two excused absences will cause a "4" in attendance, a non-excused absence will result in the failure of the course. That includes the attendance of the surgeries and Q&A sessions. The first block is absolutely mandatory! Clinical collaborators include Dr. Simon Weidert (Trauma Surgery, Navigated Orthopedic Surgery), OA Dr. S. Paepke (Minimal Invasive, Ultrasound-guided breast biopsy), Prof. Dr. Hubert Hautmann (Pneumologie, Navigated Bronchoscopy), Dr. A. Schneider and Prof. Dr. Hubertus Feußner (Minimal Invasive, Laparoscopic Surgery) ... (more to follow).

Photos Advanced Multimodality Image Guided Operating (AMIGO) Suite Digital OR integration by Brainlab Seminar at Spitzinghaus for last lecture and final presentations

Lecture Schedule of Block 1 - April 17, 2015

Time	Lecturer	Content	Material
09:00 - 09:30	Local: Dr. Jörg Traub	Introduction, Course Outline and Group Building	none
09:30 - 10:00	Video conferencing: Dr. Jörg Traub and Prof. Dr. Michael Friebe (from Magdeburg)	Introduction to the Lecturers & Final Lecture Block with trip to a mountain area	Slides Part I
10:10 - 11:30	Video conferencing: Dr. Jörg Traub	OR Visits Preperation and Medical Ethics	Slides Part II
10:30 - 11:15	Video conferencing: Prof. Dr. Michael Friebe (from Magdeburg)	Motivation & Introduction in Medical Imaging	Slides Part III
11:15 - 12:00	Video conferencing: Dr. Jörg Traub	Motivation and Introduction in Medical Image Processing and Navigation	Slides Part IV
12:00 - 13:00	lunch break
13:00 - 16:00	Local: Dr. Jörg Traub	Applications of IGS and OR Video Analysis

Lecture Schedule of Block 2 - May 22, 2015

Time	Lecturer	Content	Material
09:00 - 10:00	Video conferencing: invited presentation of Dr. Martin Groher from MicroDimensions GmbH	Applications of Image Processing in Pathology and the Creation of MicroDimensions GmbH	Slides
10:00 - 10:15		Organizational & OR codex	Slides
10:30 - 12:00	Video conferencing: Dr. Jörg Traub (from Magdeburg)	Image Processing & Navigation in a Nutshell	Slides Part VI p1  Slides Part VI p2
12:00 - 12:45	lunch break
12:45 - 04:00	Local: Prof. Dr. Michael Friebe	Imaging Systems I & II	Slides V

Lecture Schedule of Block 3 - June 19, 2015

Time	Lecturer	Content	Material
15:45 - 16:00	Local: All	Q&A – project group work for final presentation and documentation
15:15 - 15:45	Video conferencing: Prof. Dr. Michael Friebe (from Magdeburg)	Innovation Games / Conceptual Blockbusting	Innovation Games
14:45 - 15:15	Video conferencing: Dr. Jörg Traub	Project Management	Slides Part VII  Innovation Eco System
14:30 - 14:45	Video conferencing: Iurie Tap	A perspective from an alumnus of "Medical Technology Entrepreneurship"	Slides
14:00 - 14:30	Video conferencing: invited presentation from Stefan Wiesner from HumediQ GmbH	Imaging and Guidance in Radiation Therapy
13:00 - 14:00	Video conferencing: invited presentation of Dr. Hans Kiening from Arri Medical	Digitalization of Operation Microscope
12:00 - 13:00	lunch break
09:00 - 12:00	Local: Dr. Jörg Traub and every team	Midterm Presentation of OR Visits

Lecture Schedule of Block 4 - July 16-18, 2015

Time	Lecturer	Content	Material
		German Healthcare System Overview	German Healthcare System

Readings

1. D. Buckland, “How Surgeons and Engineers Can Communicate Better,” MedGadget, 08-Jul-2012. [Online]. Available: http://www.medgadget.com/2012/08/how-surgeons-and-engineers-can-communicate-better.html. [Accessed: 03-Apr-2015].
2. T. Peters and K. Cleary, Image-Guided Interventions: Technology and Applications, Auflage: 2008. New York: Springer, 2008.
3. F. L. Greene and B. T. Heniford, Minimally Invasive Cancer Management, 2nd ed. 2010. New York: Springer, 2010.
4. T. M. Peters, “Image-guidance for surgical procedures,” Physics in Medicine and Biology, vol. 51, no. 14, pp. R505–R540, Jul. 2006.
5. Ziv Yaniv and Kevin Cleary, “Image-Guided Procedures: A Review,” Georgetown University, CAIMR TR-2006-3, Apr. 2006.
6. J. K. Udupa, V. R. LeBlanc, Y. Zhuge, C. Imielinska, H. Schmidt, L. M. Currie, B. E. Hirsch, and J. Woodburn, “A framework for evaluating image segmentation algorithms,” Computerized Medical Imaging and Graphics, vol. 30, no. 2, pp. 75–87, Mar. 2006.
7. N. Ayache, O. Clatz, H. Delingette, G. Malandain, X. Pennec and M. Sermesant, “Asclepios : a Research Project-Team at INRIA for the Analysis and Simulation of Biomedical Images,” 2006.
8. K. Doi, “Current status and future potential of computer-aided diagnosis in medical imaging,” British Journal of Radiology, vol. 78, no. suppl_1, pp. S3–S19, Jan. 2005.
9. J. V. Hajnal, D. L. G. Hill, and D. J. Hawkes, Medical Image Registration. Boca Raton: Crc Pr Inc, 2001.
10. Gary Bishop, Greg Welch, and B. Danette Allen, “Tracking: Beyond 15 Minutes of Thought - SIGGRAPH 2001 Courses - Course 11.” 2001.
11. K. Cleary and C. Nguyen, “State of the art in surgical robotics: Clinical applications and technology challenges,” Computer Aided Surgery, vol. 6, no. 6, pp. 312–328, 2001.
12. J. B. A. Maintz and M. A. Viergever, “An Overview of Medical Image Registration Methods,” In Symposium of the Belgian hospital physicists association (SBPH-BVZF, 1996.
13. Ron Kikinis, David Altobelli, Langham Gleason, and Ferenc Jolesz, “Enhancing Reality in the Operating Room,” Brigham and Womens Hospital, Boston, 1993.
14. A. Wolbarst and W. Hendee, Evolving and experimental technologies in medical imaging, Radiology, 238 (2006), pp. 16-39
15. PhD Thesis - Chapter 1 & 2 - Joerg Traub, New Concepts for Design and Workflow Driven Evaluation of Computer Assisted Surgery Solutions, 2008, TUM, Munich, Germany
16. Selected Workshop and Proceedings of the following congresses: IPCAI/CARS, MICCAI, SMIT
17. POWER CARTOON ACCESS -- FOR THE PROJECT: Manuals downloadable at http://www.powtoon.com -- Student Access through here