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Designing Virtual Operating Room for Operative Interventions

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Designing Virtual Operating Room for Operative Interventions Powered By Docstoc
					Designing a Virtual Operating Room for
 Operative Interventions under Some
      Pathologies of Middle Ear.
        A Case of the Database

 Authors: S.K. Shoukourian, A.K.Shukurian,
        A.A.Avagyan, A.M. Vasilyan

                  ENT Department
               2 Koryun str., 375025
          Yerevan State Medical University
                 Yerevan, Armenia
               Tel: (3741) 56 05 94
               Fax: (3741) 52 96 05
          E-mail: ashukuryan@yahoo.com
 EXPECTED ACHIEVEMENTS
A thought simulation technology both for off-line and
on-line modes of simulation;
Simulation execution of different models of a hearing
system;
Easy changes of a model;
A simplicity for changing simulation algorithms ;
A smooth addition of a new models, simulation
algorithms and modes;
No dependence of a hearing system specific
configurations;
Easy usage of different interfaces to existing
biomedical networks and telecommunication
resources
      OBJECTIVES OF THE PROPOSED
              RESEARCH
Creation of a models and applications for predication of
operative interventions and hearing function changes
(a virtual operating room)
Creation of a cheap and justified technology for
simulation algorithms and operative interventions
strategies in off-line and on-line modes and for
different abstraction levels;
Creation of the theoretical methods and algorithms for
the design justification of models (e.g., operative
intervention);
 Creation of an object-oriented technology base
(algorithms, program utilities and interfaces) within
the existing computer-integrated environments and
telecommunication resources;
investigation of the advantages of the technology for
concrete classes of middle ear pathologies;
evaluation of the correlation degree and nature
between conductive and neurasensoral violations of
hearing;
    TECHNICAL DESCRIPTION
   A VIRTUAL OPERATING ROOM
                      A system for the
                   actuality evaluation for
                       an OI model


A control system for                        A model generation
   an OI process                             system for an OI
                                                  process



                       An operative field
      ACTUALITY EVALUATION SUBSYSTEM

                     Information flow



                   A goal strA system
A goal structure       of results       Rules of evaluation
                    evaluationucture



        A MODEL GENERATION SUBSYSTEM
                      An agent of a      A history archive
 An archive of
                         model               of models
    models
                       generation          development



                    A goal structure
      TECHNICAL DESCRIPTION
A CONTROL SYSTEM FOR AN OI PROCESS

                            A process              A surgeon
                            manager




A scheduler     A dispatcher        An agent for           An agent for
                                       error                 process
                                     correction            optimization


                                         An assistant

         An agent for process       An agent for process
             monitoring                  diagnosis
      AN OPERATIVE FIELD

  Components of
    middle ear                            A set of devices


                        A state of an
                       operative field
Adegree of a disease                           A set of
     reasons                                 instruments


                        A patient state
Groups of a disease
     reasons
AN INTERCONNECTION BETWEEN VIRTUAL
     AND REAL OPERATING ROOMS
          A virtual operating room



     An interface for a virtual operating
                    room



      Database              A diagnostic
                             equipment




            A real operating room
          TECHNICAL DESCRIPTION
   A SIMPLIFIED VERSION OF INFORMATION
                 EXCHANGE


Object 1     Object 2             Object 3         Object 4




 A list of
operation     Broker of objects              A list of
 triggers                                    assumptions



                  A clock
       AN INTERFERENCE WITH GLOBAL
           BIOMEDICAL NETWORKS

   automatic transmission of different
    medical images and data (e.g.,
    audiograms) and retransmission of
    analysis results;

   using of possibilities of 3D visualization
    within a virtual operating room;

   using of possibilities of HPC cites for
    experiments with complicated models;
          TECHNICAL DESCRIPTION
     A MODEL OF MIDDLE EAR IN A FORM OF
           INTERACTING OBJECTS
              Tympanic     Malleus     Incus    Stapes     Inner ear
Outer ear
              membrane

                                                 Stapes
              Muscles of                         muscle
              tympanic
              membrane
                                                       Horizontal
                           Tympanicc                  semicircular
                             cavity                      canal




            Eustachea        Mucous             Mastoid
              ntube         membrane           processus
Tympanic membrane                Mucous membrane
1. normal                        1. normal
2. attic perforation             2. hyperplasie
3. edge perforation              3. polyp
4. central perforation


Malleus and incus                Muscles of tympanic membrane and stapes
1. normal                        1. normal
2. affection                     2. affection


Stapes                           Eustachean tube and mastoid processus
1. normal                        1. normal
2. affection of foot plate       2. affection
3. no affection of foot plate


                Horizontal semicircular canal
                1. normal       2. affection
           A TECHNOLOGY BASE

            ALGORITHMS AND MODELS

             Algorithms of predication
Models of hearing organ and operative interventions

                   HARDWARE
       Global telecommunication networks
                 Special hardware

                    SOFTWARE
     User-friendly programming abstractions
                 Special software
     EXAMPLES OF PROBLEMS
        TO BE EXAMINED
3D VISUALIZATION AND PROCESSING DURING
   INVESTIGATION OF A TEMPORAL BONE

  DETERMINATION AND LOCALIZATION OF
        OTOSCLEROSIS HEARTHS

     SIMULATION AND DETERMINATION
 OF ACOUSTIC PARAMETERS FOR DIFFERENT
       TRANSPLANTATION MATERIALS

  INVESTIGATION OF DIFFERENT POSSIBLE
 COMPLICATION OWING TO PECULIARITIES
             OF A PATIENT
      STRUCTURE OF THE INFORMATION FIELD
           Anesthesia           Ear              Ossicular           Tympanic              Mucosa
                              channel             chain              membrane              surgery




                                 Operative Therapy                      Intervention




           Otosurgeon                   Diagnosis                  Patient                Anamnesis




                                  Pharmaceutical                  Clinical
                                     Therapy                   Examinations




Roentgen         Anatomical       Biochemical          Audiometry            Vestibular        Anesthesia
                 evaluation                              results               status



       Many to One                       Many to Many                     One to many
     (“Multiple to Single”)             ("Multiple to Multiple")        ("Single to Multiple")
   A METHOD OF DESIGN
STEPS OF A DESIGN PROCESS

      Functional Specification



          System Design



    Component Implementation
       SYSTEM DESIGN TASKS
            Allocation       Partitioning      Refinement

             Memories         Variables to      Address
Variables
                               memories        assignment
             Processors       Behaviors to     Interfacing
Behavior                       processors
Channels    Connections        Channels         Protocols


Allocation defines system components for the given functional
 specification;

Partitioning assigns functional object to allocated components;
Refinement upgrades the original specification to reflect the
 impact of a given allocation and partition.
          INITIAL REQUIREMENTS TO THE
                DATABASE SYSTEM
1. An opportunity of distributed data processing;
2. Tables, which are describing parameters of a patient examination or
technique of an operative intervention, contain too many descriptive
attributes;
3. Information can be obtained in a graphical form (for example,
roentgenograms);
4. Direct receipt of information from a diagnostic medical equipment is
possible;
5. An opportunity of real time processing;
6. Usage of data both from local and global computer-integrated
environments;
7. A differentiation of access, based on a centralized password authorization
of a user as well as on a concept of user groups with the group rights
(medical, laboratory, administrative personnel, patients) and a concept of
groups for information field resources (personal data, laboratory results,
diagnoses, operative interventions).
8. Data integrity limitations implied by the relations "single to multiple",
"multiple to multiple" and "inherence" between objects.
9. Declarative data integrity limitations, imposed by descriptive attributes.
       CLINICAL ASPECTS OF A VIRTUAL OPERATING ROOM FOR
      PREDICTION OF OPERATIVE INTERVANTIONS UNDER SOME
                  PATHOLOGIES OF MIDDLE EAR
   A retrospective review of satiating meanings for the word "virtual" in
    the area of computer sciences clearly demonstrates its development
    from a virtual storage, then a virtual machine to a virtual reality, i.e. an
    adequate 3D framework and an environment for a user generated by a
    computer. It allows without any effort to include and to merge a user
    within the mentioned environment. The virtual reality hides reading,
    writing and arithmetic and replaces it by direct, non-symbolic
    environmental experience. The problems of a virtual reality turned to
    be specially important for novel complicated and higher-precision
    technologies. At the same time these technologies very rapidly become
    obsolete and the main problem here is a great contradiction between
    the time of determining optimal modes and possibilities of such a
    technology and the time of a new technology creation.

   This is the reason why investigations in the area of virtual high-
    precision technologies are considered as the most global and important
    problems within many national and international perspective scientific
    programs. All the existing achievements in modern information
    technologies and computer-integrated environments including global
    networks, communication resources, multimedia, etc. are serving to
    achieve solutions for these problems.
   On the other hand, an intensive development of a surgical medical
    instrument set and tools (microscopes, lasers, computer monitoring,
    etc.), a tendency of decreasing essentially a time interval between a new
    and a typical operative intervention and a tendency of increasing
    essentially a complexity of operative interventions and a number of
    surgical patients allow to ascertain as the determining for the present
    and the nearest future a creation of high-precision, complicated,
    computer-integrated and, at the same time, rapidly becoming obsolete
    technologies of operative interventions.

   The described situation is very typical for otosurgery which could be
    characterized, on one hand, by a complexity of a miniature hearing
    organ, a usage of a very high-precision instrument set, essential
    contradictions among scientific references on operative interventions
    and, on the other hand, a relatively compact and simple operative
    environment.

   All the mentioned characteristics make otosurgery evidently suitable for
    experiments on its immersion into a computer-integrated environment.

   The planned system will make simulation and prediction of operative
    interventions transparent and empower the participant with natural
    interaction. The technical challenge is to create mediation languages and
    tools which enforce rigorous mathematical computation while supporting
    intuitive behavior.

   The system will be based on new possibilities of computer-integrated
    environments and will be presented in a form of a virtual operating room.

				
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posted:7/26/2011
language:English
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