Laparoscopy is a minimally invasive surgical procedure, often known as “keyhole” surgery, because it only uses small incisions. Obviously, because incisions are only 0.5–1.5 cm. wide, surgeons have to use imaging techniques to see what is inside of patient‘s body.
But over the last half century imaging techniques, used in laparoscopy has seen only incremental improvements. However, now scientists in the University of Wisconsin-Madison are developing a revolutionary integrated imaging system, which should significantly advance laparoscopy.
Laparoscopy is used for procedures in the abdominal area, including surgery on the colon, stomach, oesophagus or reproductive organs, among many others. During the surgery doctor navigates through three to five ports, or trocars, placed in small incisions in the abdomen with the assistance of a video camera and long, thin instruments.
However, although such procedure is very beneficial for patients, laparoscopy is quite difficult to perform. Camera has to be operated by another person, not surgeon himself, so surgeon has to say when to focus, where to point it and so on. Furthermore, camera uses one of the trocars. Currently used cameras also have limited field of view, which is why scientists set out to make a new imaging system.
It takes advantage of variable focal length micro lens systems, developed earlier in the University of Wisconsin-Madison. This new system uses retractable micro lens arrays, which are miniature wireless video cameras, integrated into the end of each instrument used in the laparoscopy. When these instruments are inserted, cameras will flare out in a ring, allowing the surgeon to use the port simultaneously for imaging and performing the surgery.
Surgeon himself will be able to operate the cameras, using voice commands or other input devices. He will be able to tune the focus of each camera to adjust the depth of field, which improves the image quality. Use of multiple cameras will create an immersive, three-dimensional view of the procedure, but because cameras will be further away from the procedure spatter will be avoided. These features are part of holistic approach – this new imaging system solves most of problems that current systems have.
Professor Hongrui Jiang, pioneer of variable focal length microlens systems, used in this new laparoscopic imaging technique, noted that these cameras will not cause any extra trauma to the patient, because it will use existing ports.
Professor Jiang has been developing microlens systems for more than a decade and established collaboration with laparoscopic surgeons in order to introduce them into clinically relevant applications. He said – “this whole project was generated and driven by both sides — from the pursuit to address engineering challenges to the pursuit to solve clinical and medical problems. The advantage of our approach is that we gave the clinical requirements and disadvantages a lot of thought so that we could come up with a comprehensive solution to address all of the problems.”
Although achievements are already pretty impressive, scientists will continue to work on improving this technique, until it is ready to be used extensively in hospitals around the world. At first they will continue to refine the lens and camera technology, but they also have to develop software. This technology needs algorithms for processing the images from multiple cameras and joining them into a single, 3D view. Finally, prototypes for laparoscopic simulators have to be developed, so that they could see how surgeons manage to use this novel system. Because of disadvantages of current laparoscopy techniques, surgeons now have to get used to controlling cameras themselves.
When technology is advanced even further, team of scientists expects it to extend throughout other minimally invasive surgery fields as well. Especially having in mind that surgeons are saying that this technology really is useful and could revolutionize laparoscopy altogether. However, it will still take a lot of time for scientists and surgeons to finely tune the equipment and to introduce it for clinical use.