Four firsts of cyber-surgery combining robotics and digital imaging were performed between January and July at the brand new University Hospital Institute of Strasbourg in eastern France, announced Monday an expert in this specialty, Professor Jacques Marescaux.
A liver operated thanks to "augmented reality", an oesophagus repaired thanks to virtual surgery, a neck cleansed using 3D images: less intrusive, cyber-surgery is a surgery of the future, according to a specialist who reports four firsts performed this year in Strasbourg.
"This hybrid surgery is the convergence of techniques and specialties (surgeons, gastroenterologists, radiologists...) and a mix of instrumentation, imaging equipment and robotics," explains Professor Jacques Marescaux, surgeon and founder of the IRCAD (Institute for Research into Cancer of the Digestive System).
"This is the surgery of the future", according to this expert who, in 2001, made a name for himself by operating from New York, using a robotic console, on the gall bladder of a patient in Strasbourg ("Operation Lindbergh").
He thus presided over four firsts of image-guided "mini-invasive" surgery between January and July at the brand new Institut Hospitalo-Universitaire de Strasbourg (IHU). An establishment, within the University Hospital Center, equipped with state-of-the-art equipment, of which he is the initiator.
Three of these operations represent world firsts, Prof. Marescaux told AFP: the use of virtual reality as an aid to diagnosis and surgical strategy in neck surgery, major surgery for colorectal cancer, without scarring, through natural channels, and robotic liver surgery assisted by augmented reality.
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Moreover, an operation without scarring on the oesophagus by natural means had not been performed in France until now.
For the neck surgery of a 66-year-old patient suffering from a pathology of a parathyroid gland (an adenoma), virtual surgical exploration - a reconstruction from 3-dimensional scanner (or MRI) images of the gland using software developed at the IRCAD - made it possible to detect an anomaly of an artery, which is associated with an anomaly of the path of the voice nerve not detected by the standard preoperative check-up.
"The use of virtual reality made it possible to guide the surgical procedure in a personalized way and to preserve this hidden nerve," says the surgeon.
Transparent Liver
This type of software, along with MRI, could also be used in prostate surgery to avoid touching nerves that can cause impotence. The "minimally invasive" operation on the esophagus of an 82-year-old patient who could no longer eat was done with a flexible instrument introduced through the mouth (endoscope), instead of laparoscopy (also called laparoscopy). The patient returned home three days after the operation and ate normally again.
In ten years' time, this type of intervention by natural means will be the rule," says Prof. Marescaux. They have the merit of shortening the length of hospitalisation and reducing surgical trauma. »
Last July, Prof. Patrick Pessaux paved the way for cyber liver surgery guided by augmented reality. This impressive operation on a liver tumour used robotics and virtual reality images that were merged in real time during the operation with the images provided by the camera introduced into the patient's body. Constant exchanges between the surgeon and the computer engineer allow visual navigation through anatomical structures, making the liver transparent with visualization of all blood vessels normally invisible, for greater safety. The 36-year-old patient was able to return home one week later. (Source AFP)
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