Future technology

Abstract

While during the decade since 1995 the computer has represented an essential tool for the surgeon mostly because of its use as a support for storage of patient data or for scientific presentations at meetings, more recently the ability to obtain rapid data processing and exchange through computer-generated programs is having a tremendous impact on all aspects of surgery, creating the basis for a true revolution of diagnosis, therapy, and the teaching of surgery. Although there is the inevitable tendency to consider computer-generated virtual reconstructions as fascinating laboratory work with small actual impact on the routine of the general surgeon, some applications are emerging from the scrutiny of scientific investigations and will very reasonably become commonplace in the foreseeable future. Computer-generated three-dimensional (3-D) images that reconstruct anatomical and pathological structures and the possibility to translate medical information contained in images into a set of 3-D models, allow to visualize structures from multiple points of view as well as to develop an actual interaction of virtual instruments with the virtual organs. Applications of these virtual reality systems provide new potentialities for education and training, preoperative diagnostics, preoperative planning, and intraoperative and postoperative applications. The computer also allows digitization of the surgical movements and images. Once digitized, this information can be modified to filter and exclude non-finalized movements, for example physiological tremor of the surgeon (Garcia-Ruiz et al. 1998), resulting in greater dexterity and higher precision for performance of difficult tasks (Damiano et al. 2000; Falcone et al. 2000; Reichenspurner et al. 1999), which is one of the advantages of robotic surgery. Furthermore, computer programs can be used to convert video images and surgical movements into electronic signals, which, after being appropriately compressed with algorithms, can be transmitted to distant sites enabling the performance of remote surgery. In this chapter we discuss the role of new technologies in surgery by reporting the main applications currently under evaluation at the European Institute of Telesurgery of Strasbourg (EITS) as well as trying to pinpoint current limitations and possible future developments. © Springer-Verlag Berlin Heidelberg 2008.