Image-Guided Procedures

Abstract Over the past two decades, significant efforts have been dedicated to minimizing the invasiveness associated with surgical interventions, which has been made possible by advancements in medical imaging, surgical navigation, visualization, and display technologies. Modern image-guided interventions or image-guided surgical techniques have now been in use for approximately 30 years, beginning with stereotactic brain surgery and slowly becoming used in orthopedics, spinal, cardiac, and abdominal areas. The successful implementation of an image-guided surgical platform must localize and track the position of the surgical tool or therapeutic device, register a localized volume with preoperative data, and present this information to the surgeon in an intuitive display. In many cases, preoperative data are complemented with intraoperative imaging. This chapter provides an overview of image-guided surgical techniques and provides as examples some of the systems in which the authors have experience. We begin with a discussion of medical imaging modalities, along with the processing and data analysis techniques as well as instrument tracking, that are critical components of any image-guided surgical environment, and follow with specific examples of image-guidance used in orthopedics, abdominal, neurological, and cardiac surgery. The chapter concludes with a brief discussion of the current challenges related both to the technology and the regulatory environment.

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