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Using OsiriX to Guide Surgery

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Apple's Web site has a feature on the use of OsiriX, a mac-based open-source software system for viewing radiologic images. A surgical team at Teikyo University Chiba Medical Center in Japan uses Osirix to project "surgical roadmaps" on patients as they perform minimally invasive surgery.
For patients with early-stage gastric or colonic cancer, the surgical team typically opts for minimally invasive laparoscopic surgery. With the patient anesthetized, Sugimoto projects OsiriX-generated 3D images onto the body surface of the patient with an Epson EMP-1715 projector. Using a motion-sensing wireless remote, Sugimoto uses physiological markers (such as the navel) to register the image to the patient’s body. Then using a Color Look Up Table (CLUT) feature in OsiriX, he makes the skin of the image transparent. The display now shows the patient’s internal body parts and the area that he will need to operate on.


Osirix, which is easy to learn, allows the surgeons to use the 3D images as a reference and guide during surgery. The images may be rotated to provide the surgeons a real-time view of the operation. The remote may also be linked to the laparascope, allowing the image on the display and the image on the scope monitor to move simultaneously. Dr. Sugimoto provides more details on the use of Osirix during surgery:
“The 3D visualization shows us relationships between the cancer and the
arterial vessels and other surrounding organs,” says Sugimoto. “It also
allows us to see the extent of the spread of cancer. When a patient has
upper biliary (bile duct) cancer, we have to cut the liver. If the
patient has lower bile duct cancer we have to remove the pancreatic
head and duodenum. The HBP system is very complex; that’s why 3D
visualization in the OR is so crucial. When doing a midline open
surgery, the surgeon can only see the organs from the top. With OsiriX
on the Mac, surgeons can rotate and see the surrounding organs in 3D to
guide them during surgery.”
More information on OsiriX may be found here.
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About the Author


MD, FACP, FASN

Dr. Schwimmer's blog explores the intersection of medicine, new technologies, and the Internet.

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