A flexible sideways-looking probe for detecting cortical bone proximity: design, manufacturing, and evaluation of a prototype

Spinal fusion is a surgical treatment involving stiffening parts of the spinal column to eliminate any relative motion and improve spine stability. A critical part of spinal fusion surgery is the placement of pedicle screws because it is highly complex and can damage the vascular structures and nerves near the vertebrae. To prevent complications...

Combining diffuse reflectance spectroscopy and ultrasound imaging for resection margin assessment during colorectal cancer surgery

Establishing adequate resection margins during colorectal cancer surgery is challenging. Currently, in up to 30% of the cases the tumor is not completely removed, which emphasizes the lack of a real-time tissue discrimination tool that can assess resection margins up to multiple millimeters in depth. Therefore, we propose to combine spectral...

Powered hammering a diffuse reflectance spectroscopy equipped K-wire: Examining insertion control and optical capabilities

Background Inter- and intra patient morphological differences and absence of visual feedback make the placement of pedicle screws technically very demanding. As the spine is surrounded by neurovascular tissue, complications can have severe consequences, including paralysis. Guidance techniques are often very expensive and can overexpose surgeons...

Optical performance and drilling forces of an orthopaedic DRS drill with a stagnant optical probe

Introduction. In spinal surgery, the misplacement of spinal screws is a problem that causes (severe) pain, bleedings or even paralysis [2]. Screw misplacements are common as navigating in the spine is difficult due to the small vertebral dimensions and a lack of anatomical landmarks [3] [4]. In order to improve the navigational support of spine...

Optical performance and drilling forces of an orthopaedic DRS drill with a stagnant optical probe (Article): An article on a Biomedical Engineering Master thesis about orthopaedic DRS drilling at the Delft University of Technology

In spinal surgery, the misplacement of spinal screws is a common problem that causes (severe) pain, bleedings or even paralysis [1] [2] [3]. In order to improve the navigational support of spine surgeons, this research focuses on the development of an optical sensing diffuse reflectance spectroscopy (DRS) orthopaedic drill that identifies bone...

Diffuse reflectance spectroscopy for breach detection during pedicle screw placement: a first in vivo investigation in a porcine model

BACKGROUND: The safe and accurate placement of pedicle screws remains a critical step in open and minimally invasive spine surgery, emphasizing the need for intraoperative guidance techniques. Diffuse reflectance spectroscopy (DRS) is an optical sensing technology that may provide intraoperative guidance in pedicle screw placement. PURPOSE:...

Automated classification of brain tissue: Comparison between hyperspectral imaging and diffuse reflectance spectroscopy

In neurosurgery, technical solutions for visualizing the border between healthy brain and tumor tissue is of great value, since they enable the surgeon to achieve gross total resection while minimizing the risk of damage to eloquent areas. By using real-time non-ionizing imaging techniques, such as hyperspectral imaging (HSI), the spectral...

Towards real-time identification of brain tumors by integrating diffuse reflectance spectroscopy in a neurosurgical instrument

Brain tumors account for approximately just 2% of all cancers worldwide, but have a noticeable impact on cancer morbidity and mortality. Removal of brain tumors poses a big challenge for neurosurgeons, pediatricians and neuro-oncologists. An important aspect of this challenge is to adequately differentiate between tumor tissue and healthy brain...

Tissue diagnosis during colorectal cancer surgery using optical sensing: An in vivo study

Background: In colorectal cancer surgery there is a delicate balance between complete removal of the tumor and sparing as much healthy tissue as possible. Especially in rectal cancer, intraoperative tissue recognition could be of great benefit in preventing positive resection margins and sparing as much healthy tissue as possible. To better...

Evaluation of a smart electrosurgical knife: assessing the feasibility of tumour detection with Diffuse Reflectance Spectroscopy in breast conserving surgery

Every year, 1.7 million woman are diagnosed with breast cancer worldwide. Breast Conserving Surgery (BCS) – where not the whole breast but only the tumour is dissected – is the most common and preferable treatment for these woman. However, 20 to 55% of the patients’ needs a second surgery because of positive margins. A dissected tumour has a...

The design of a user interface for a photonic tool

Diffuse reflectance spectroscopy (DRS) allows spectral tissue sensing through optical fibers at the tip of a needle, endoscope, or other medical device. A so-called photonic tool could be applicable in a variety of application areas to aid in diagnostic decisions or to support image-guided procedures. The use of light in combination with medical...