Surgery is a key treatment option for prostate cancer patients which is rapidly evolving with the rise of minimally invasive robotic techniques and image-guided surgery. In these approach, Enhanced... Show moreSurgery is a key treatment option for prostate cancer patients which is rapidly evolving with the rise of minimally invasive robotic techniques and image-guided surgery. In these approach, Enhanced dexterity and decision-making, help improve the surgeon-robot-patient interaction. By improving this level of interaction, surgery can achieve a level of precision that leads to improved patient outcomes. As such, improved environmental awareness during surgery can aid more precise targeting of cancerous tissues and better protection of healthy tissues. This means that technological innovations, such as target-specific radiopharmaceuticals and advanced surgical sensory modalities, are necessary to enhance surgical perception. The influence of such perception-enhancing technologies on surgeons' actions can best be objectively assessed by analyzing the movements of surgical instruments, performed during these procedures. Digitized instrument kinematics provide a wealth of data representative of the interaction dexterity and decision-making that, until now, has been largely neglected in the field of image-guided surgery. This work represents a significant first step toward incorporating interactive perception assessments into image-guided surgery. The aim is to evaluate the influence of newly developed technologies and guide the design of future advancements. Show less
The main objectives of this thesis are to obtain clinically relevant tools to evaluate quality during the introduction of new interventions in laparoscopic hysterectomy (LH) (the most frequently... Show moreThe main objectives of this thesis are to obtain clinically relevant tools to evaluate quality during the introduction of new interventions in laparoscopic hysterectomy (LH) (the most frequently performed advanced gynecological minimally invasive procedure) and to support clinicians to ensure surgical safety by means of process analysis. We performed a Delphi study to achieve consensus on a uniform and multidisciplinary applicable definition. Based on this definition, we described the relevance, evidence and controllability of conversion rate as a means of evaluation in LH. We performed a systematic review with cumulative analysis to evaluate the outcomes of abdominal, laparoscopic and vaginal hysterectomy (VH) in patients with a BMI ≥35kg/m2 and concluded that the feasibility of LH and VH should be considered prior to the abdominal approach to hysterectomy in these patients. Furthermore, we performed a prospective study using video observation, to assess the incidence and effect of equipment-/instrument-related surgical flow disturbances during LH and validated a questionnaire to detect potential safety hazards during the introduction of new interventions in an early stage. Finally, the Digital Operating Room Assistance (DORA) model was introduced which is a novel system for automated procedural progress monitoring that enables prediction of the remaining procedure duration. Show less
