New technology provides an interactive 3D view of organs during surgery
A research collaboration in Gothenburg has developed technology that creates an interactive 3D image of an organ during surgery. This makes it easier, for example, to remove a tumor that would otherwise remain hidden beneath the organ’s surface.
With the new technology, the surgeon places a small sticker with a QR code on the organ being operated on. So far, the technology has only been tested on the liver. As long as the camera can track the marker, the surgeon can see tumors and other structures beneath the surface.
“It is a bit like having GPS navigation inside the organ. Instead of simply having a map before surgery, we receive continuous guidance based on the current camera angle,” says Niclas Kvarnström.
He is a transplant surgeon and Head of the Transplant Centre at Sahlgrenska University Hospital, and a researcher at Sahlgrenska Academy at the University of Gothenburg.
“We have previously been able to create a three-dimensional image, but it has not been reliable because the organ changes during surgery. If we wanted an updated ultrasound image, we had to interrupt the procedure,” says Niclas Kvarnström.
Hidden structures become visible
The new technology links a three-dimensional image of the patient’s anatomy to the surgical field and displays it in relation to the surgeon’s camera view. Using augmented reality, tumors, blood vessels, and other anatomical structures hidden beneath the organ’s surface can be made visible to the surgeon directly in the surgical field. The information is continuously updated as the camera changes position.
“This means that computer-generated content is overlaid on the physical world. It is a bit like Pokémon GO, but with much greater precision.”
Hospital–academic collaboration
The technology was developed through a collaboration between Sahlgrenska University Hospital, Chalmers University of Technology, and the University of Gothenburg. Chalmers Ventures helped establish a company to develop the technology further.
The collaboration dates back ten years, to when the Imaging and Intervention Centre at Sahlgrenska University Hospital had recently opened. Surgeons Niclas Kvarnström and Mårten Falkenberg were in contact with Torbjörn Lundh and Klas Modin, professors in the Department of Mathematical Sciences at Chalmers and the University of Gothenburg.
The initial focus was on using diagnostic imaging in hybrid operating rooms and developing minimally invasive methods, including in liver and tumor surgery.
First operation on a human patient
The road to the first operation has been long, involving several years of technical development, preclinical studies, and testing of the system in different scenarios. The first operation on a human patient was performed in June of this year.
“The system could be used as planned during the operation, and the workflow ran smoothly. The patient was able to go home the following day,” says Niclas Kvarnström.
More surgeries and further development
Further operations are planned for the fall. In parallel, work continues on clinical validation, product development, quality management systems, and the regulatory pathway to market approval. In the longer term, a larger international study is planned.
Although the first clinical application has been in liver surgery, Niclas Kvarnström sees potential in other areas too.
“This technology can be used in many routine procedures, for tumors in other organs, or to track specific anatomical structures. We are starting with liver surgery, but in time the technology could have much broader applications,” he says.
Research driven by surgical needs
Torbjörn Lundh considers this a good example of needs-driven research:
“This grew out of a real need in the operating room. Together with our thesis students, Klas and I have applied and developed the mathematics needed to visualize where the tumor is hidden.”
Text: Sahlgrenska University Hospital
The work has already resulted in a number of scientific publications and several degree theses at Chalmers. A company, Navari Surgical, has also been established to develop the technology into a medical device. This has enabled the project to secure funding from Vinnova, Chalmers Ventures, and several private investors, among others. Region Västra Götaland has contributed support in areas including contracts and innovation.
Three Chalmers students contributed to the project through their degree theses before the company was established: Lisa Månsson, Christian Almaleh, and Carl Bodin.