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Operating rooms are scary places at the best of times, and when going under the knife, you’d like to know that a surgeon’s itchy nose or her morning’s double espresso isn’t going to cause any accidents. This is where medical robotics can ride in to the rescue. As a PhD student developing intelligent surgical instruments, I design algorithms that aid surgeons in procedures. One of the fundamental problems of helping someone is knowing what they are trying to do. Handing a hammer to a construction worker when he is pouring concrete is not terribly helpful.
A popular solution is to use computer vision: attach some cameras to the microscope, see what the surgeon is doing, figure out what her goals are, and then provide assistance. For instance, microinjections of veins smaller than a human hair are very useful procedures that are currently too difficult to perform reliably in the operating room. Our tool reduces surgeon tremor and uses image analysis at high magnification to guide the needle into the vein, increasing the success rate of the procedure. Unfortunately, many of the useful algorithms are difficult to perform in real-time. Furthermore, different algorithms are often required in parallel: several methods might track the tip of the instrument, another builds 3D representations of the tissue surface, and still others run analysis to detect and diagnose blood leakages or diseased areas.
Currently, I run a number of algorithms and am forced to make compromises even with powerful quadcore machines. With modest stereo 800×600 resolution cameras that run at 30 Hz, 5 gigabytes of images need to be processed every minute. This increases to upwards of 40 GB/min with high speed or high-definition cameras. Trying to analyze the sheer number of pixels coming is much like the analogy of trying to drink from a fire hose. Simply encoding and saving the video in real-time for post-op review becomes challenging. Consequently, I run tracking algorithms at lower resolutions, sacrificing precision for speed. Diagnoses are performed pre-operatively or manually on demand during pauses in the procedure. 3D representations of the tissue are built initially and updated only infrequently. This affects the level of assistance the system provides to the surgeon.
In fact, significant amounts of my time go towards optimizing C++ or even assembly level code to maximize performance. Reducing L1 cache misses, utilizing branch predictions, and rewriting code to take advantage of SIMD instructions let me run more algorithms and provide better aid to the surgeon. Even with such optimizations, I am still hitting the limits of what four cores can do. However, a most encouraging aspect of computer vision is its often embarrassingly parallelizable nature. With a 48 core machine, I could do a significantly better job. I would move to higher definition video for much greater precision, parallelize my tracking algorithms for enhanced speed, run advanced stereo algorithms for high quality 3D reconstructions, and thus more effectively provide the surgeon with aids that make the operating room a less scary place.