Image Guided Surgical Interventions

urgeons have traditionally performed procedures to treat diseases by aining direct access to the internal structures involved, and using direct isual inspection to diagnose and treat the defects. Much effort has gone nto identifying the most appropriate incisions and approaches to enable ull access inside body cavities, specific organs, or musculoskeletal tructures. Imaging has traditionally been used primarily for preoperative iagnosis and at times for surgical planning. Intraoperative imaging, hen used, was meant to provide further diagnostic information or to ssess adequacy of repair. In most cases radiograph static images or uoroscopy have been used in the operating room. As the application of ess invasive procedures has progressed, other imaging technology has een applied in an effort to address the limitations of simple radiographs r fluoroscopy. Computed tomography (CT), magnetic resonance imagng (MRI), ultrasound, nuclear radiographic imaging, and modified ptical imaging have been introduced to provide the information required o plan and perform complex interventions inside the body without the eed for direct open visual inspection. In parallel with the developments in imaging modalities, endoscopic urgery has advanced with the introduction of rigid and flexible scopes quipped with video cameras to magnify and display the image obtained. dvances in optics and digital electronics have combined to provide nparalleled image quality even with small diameter scopes, resulting in n explosion of endoscopic procedures involving virtually every structure n the body. The only real limitation to imaging has been the inability o see or “image” through opaque structures, since the irradiating or illuminating” energy provided through the scope has been almost xclusively visible light. This limitation has confined endoscopic surgery o areas where a natural body cavity or physical space can be accessed ith a scope and instruments, and filled with nonopaque medium such as gas or clear fluid. Despite these limitations, optical endoscopy has evolutionized the way many surgical procedures are performed, and has pawned a whole industry of instrument manufacturers that, in conjunc-