Digitalization of surgical features improves surgical accuracy via surgeon guidance and robotization.

Journal: NPJ digital medicine
Published Date:

Abstract

The evolution of surgical techniques aims to augment surgeons' capabilities through digital guidance and robotization for higher precision and consistency. Currently, surgeries heavily rely on surgeon's experience and visual judgment, causing operation variations. Artificial intelligence (AI) offers a solution by extracting and digitizing surgical trajectories and features from videos to provide digital guidance. In this study, we collected 17,538 videos of capsulorhexis, a crucial step in cataract surgery, to create an AI-driven system named Meta Surgery (MetaS). MetaS evaluates and identifies ideal cases, extracts their digital characteristics, and fits an optimal capsulorhexis path in real-time during surgery. Surgeons performed capsulorhexis benefited from MetaS's guidance and a lens caliper, which increased the rate of ideal capsulorhexis by ~40%. Additionally, these digital features enabled a surgical robot to perform precise capsulorhexis autonomously in porcine eyes. This approach augments surgeons' surgical skills and paves the way for the autonomous operation of surgical robots.

Authors

  • Xiaoyun Chen
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Jiali Liu
    Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
  • Hongli Liang
    School of Artificial Intelligence, Sun Yat-sen University, Guangzhou, China.
  • Zelin Chen
    School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, China.
  • Zitian Liu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Yingfeng Zheng
    State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.
  • Zhangkai Lian
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Lixia Luo
    State Key Laboratory of Ophthalmology, Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China.
  • Weirong Chen
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
  • Mingxing Wu
  • Danying Zheng
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Xialin Liu
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Bing Cheng
  • Shengsong Huang
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
  • Xinyu Zhang
    Wenzhou Medical University Renji College, Wenzhou, Zhejiang, China.
  • Ling Jin
    Research Center for Translational Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China.
  • Yan Luo
    School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social risk Governance in Health, Chongqing Medical University, Chongqing 400016, China.
  • Zhenzhen Liu
    Department of Functional Science, School of Medicine, Yangtze University, No.1 Nanhuan Road, Jingzhou City 434100, China.
  • Erping Long
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Xian Lie South Road 54#, Guangzhou, 510060, China.
  • Patrick Yu-Wai-Man
    From the Singapore National Eye Center (D.M., D.T., S.S., C.-Y.C., T.Y.W.), Singapore Eye Research Institute (D.M., R.P.N., D.T., C.V., S.S., C.-Y.C., T.Y.W.), Duke-NUS Medical School (D.M., R.P.N., D.T., S.S., C.-Y.C., T.Y.W.), Institute of High Performance Computing, Agency for Science, Technology, and Research (J.Z., X.X., Y.L.), and Yong Loo Lin School of Medicine, National University of Singapore (S.S., T.Y.W.) - all in Singapore; Farabi Eye Hospital, Tehran University of Medical Science, Tehran, Iran (M.A.F.); the Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, and the Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal (P.F.); the Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (K.V.); the Eye Center, Medical Center, University of Freiburg, Freiburg (W.A.L.), and the Department of Ophthalmology, Ruprecht Karl University of Heidelberg, Mannheim (J.B.J.) - both in Germany; IRCCS Istituto delle Scienze Neurologiche di Bologna, Unità Operativa Complessa Clinica Neurologica, and Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy (C.L.M.); the Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong (C.Y.C.), and Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou (H.Y.) - both in China; the Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark (S.H.); the Department of Ophthalmology, University Hospital of Grenoble-Alpes, and Grenoble-Alpes University, HP2 Laboratory, INSERM Unité 1042, Grenoble (C.C.), Service d'Ophtalmologie, Unité Rétine-Uvéites-Neuro-Ophtalmologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux (M.-B.R.), the Department of Ophthalmology, Lille Catholic Hospital, Lille Catholic University, and INSERM Unité 1171, Lille (T.T.H.C.), the Department of Ophthalmology, University Hospital Angers, Angers (P.G.), and Rothschild Foundation Hospital, Paris (C.C.-V.) - all in France; the Department of Clinical Neurosciences, Geneva University Hospital, Geneva (N.S.); the Department of Neurology, SUNY Upstate Medical University, Syracuse, NY (L.J.M.); the American Eye Center, Mandaluyong City, Philippines (R.K.); Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London (P.Y.-W.-M.), and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, and Cambridge Centre for Brain Repair and Medical Research Council Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge (P.Y.-W.-M.) - all in the United Kingdom; the Save Sight Institute, Faculty of Health and Medicine, University of Sydney, Sydney (C.L.F.); the Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN (J.J.C.); the Department of Neuro-ophthalmology, Sankara Nethralaya, Medical Research Foundation, Chennai, India (S.A.); the Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore (N.R.M.); and the Departments of Ophthalmology and Neurology, Emory University School of Medicine, Atlanta (N.J.N., V.B.).
  • Weishi Zheng
    School of Data and Computer Science, Sun Yat-sen University, Guangzhou, China.
  • Kai Huang
  • Haotian Lin
    State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou.
  • Yizhi Liu
    School of Computer Science and Engineering, Hunan University of Science and Technology, Xiangtan, China.

Keywords

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