MRI-guided robot-assisted interventions: An opportunity and a challenge in computational surgery

Currently, we are witnessing the rapid evolution of minimally invasive surgeries (MIS) and image-guided interventions (IGI) for offering improved patient management and cost effectiveness. It is well recognized that sustaining and expanding this paradigm shift would require new computational methodology that integrates multimodal sensing (including imaging), controlled systems (including robots and smart actuators), the patient and the operator (e.g., [1-9] and references therein). Looking into the potential future evolution in MIS and IGI among the sought directions is the incorporation of real-time image guidance (RTIG) that can provide volumetric and high information-content visualization of the Area of Operation (AoO). Such approach would include (1) assessing in real-time tissue deformation secondary to the procedure and physiologic motion, (2) monitoring the tool(s) in 3D, and (3) updating information about the pathophysiology of the targeted tissue. With those capabilities, RTIG may facilitate a paradigm shift and methodological leap from keyhole visualization (i.e., endoscopy or laparoscopy) to one that uses a volumetric and information-rich perception of the AoO. This capability may eventually enable a wider range and level of complexity IGI and MIS [8, 10-12].