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innovative, if the actual invention (the “new” stuff) is perceived valuable by the clinical user and translated to a commercial product. With that in mind basic knowledge of health economics seems inevitable knowledge for future medical technology innovators. Design thinking, value proposition canvas, lean engineering [ 3 , 4 ] are innovation techniques that these students should be exposed to before they start their final thesis. 2 Lecture format We designed a new lecture format that would give the students some basics in the area of image guided surgeries [ 5 ] and

Current Directions in Biomedical Engineering 2017; 3(2): 235–237 Holger Fritzsche*, Axel Boese and Michael Friebe INNOLAB- image guided surgery and therapy lab Run by engineers at a hospital for interdisciplinary and useful innovation with clinicians Abstract: Incremental innovation, something better or cheaper or more effective, is the standard innovation process for medical product development. Disruptive innovation is often not recognized as disruptive, because it very often starts as a simple and easy alternative to existing products with much

Introduction Preservation of functional brain tissue is essential during neurosurgery. For surgical interventions near eloquent brain areas, knowledge about the localization of those areas is of vital importance. Eloquent areas can be identified preoperatively using functional imaging methods such as functional magnetic resonance imaging (fMRI) or positron emission tomography. The functional three-dimensional (3D) data sets can be used intraoperativly within a neuronavigation system for image-guided surgery. However, opening the cranial bone can lead to brain

content of bile is hypothesized to be influenced by fasting routines prior to operation. This, along with deviations from Beer–Lambert linearity due to scattering or aggregation make the quantification of bile in tissue challenging. This also limits the possibility of using bile as a signature for classification algorithms in image-guided surgery. One approach to solve this issue is to use deeper-penetrating NIR radiation and to characterize the bile spectrum based on water and lipid content. These water–lipid peaks were the basis of Zuzak et al. [ 15 ] analysis in

autofluorescence are minimum in the NIR window, thus enabling real-time image-guided surgery [ 10 ], [ 11 ]. While nuclear imaging provides quantitative depth information due to high gamma penetration, optical fluorescence imaging provides relatively high temporal and spatial resolution [ 12 ], [ 13 ], [ 14 ], [ 15 ]. It is therefore ideal to develop an integrated imaging system by combining NIR fluorescence and gamma-positron imaging to provide surgeons with highly sensitive and quantitative detection of diseases, such as cancer, in real-time without changing the look of the

Introduction Already for decades image-guided surgery (IGS) systems assist surgeons in accurate intraoperative navigation in interventions such as cochlear implant placement and lateral skull base surgery [ 1 ]. These systems display surgical information on a separate display, requiring the surgeon to divert attention and look away from the surgical scene. This can not only be inefficient for precise neurosurgery in critical brain areas such as the brainstem but also a cause for errors. Placing an auditory brainstem implant (ABI) on the cochlear nucleus located

.26.14826 [19] Meyer T, Sobottka SB, Kirsch M, et al. Intraoperative optical imaging of functional brain areas for improved image guided surgery. Biomed Tech 2013; 58: 225–236. 10.1515/bmt-2012-0072 [20] Nariai T, Sato K, Hirakawa K, et al. Imaging of somatotopic representation of sensory cortex with intrinsic optical signals as guides for brain tumor surgery. J Neurosurg 2005; 103: 414–423. 10.3171/jns.2005.103.3.0414 [21] Odom JV, Bach M, Brigell M, et al. ISCEV standard for clinical visual evoked potentials (2009 update). Doc Ophthalmol 2010; 120: 111–119. 10.1007/s10633

cases. Keywords: cranial navigation; electromagnetic sensor; frameless stereotaxy; image-guided surgery; neuro- navigation. Einleitung Neuronavigations-Systeme ermöglichen es, besonders in schwierigen und unübersichtlichen Operationsfeldern, sowohl Trepanationen und Kortikotomien unter Scho- nung funktionell wichtiger Hirnareale gezielt vorzuneh- men als auch kleinere, tief gelegene Hirnläsionen sicher aufzufinden. Verschiedene solcher Systeme haben bereits im Verlaufe der 1990er Jahre technische Reife erreicht, aufgrund weltweit parallel verlaufender Entwick

presented process allows the patient specific individualization of a drill guide under sterile conditions. This might facilitate its integration into clinical routine. Keywords: cochlear implant, micro-stereotactic frame, drill guide, temporal bone, drilling accuracy, image-guided surgery, direct cochlear access. 1 Introduction A cochlear implant (CI) is a neuroprosthesis which serves to restore hearing in patients suffering from severe hearing loss or deafness. Hearing restoration can be achieved by electric stimulation


Intraoperative optical imaging (IOI) is a method to visualize functional activated brain areas during brain surgery using a camera system connected to a standard operating microscope. Three different high-resolution camera systems (Hamamatsu EB-CCD C7190-13W, Hamamatsu C4742-96-12G04, and Zeiss AxioCam MRm) have been evaluated for suitability to detect activated brain areas by detecting stimulation-dependent blood volume changes in the somatosensory cerebral cortex after median nerve stimulation. The image quality of the camera systems was evaluated in 14 patients with tumors around the somatosensory cortex. The intraoperative images of the brain surface were continuously recorded over 9 min. With all three camera systems, the activity maps of the median nerve area could be visualized. The image quality of a highly sensitive electron-bombarded camera was up to 10-fold lower compared with two less sensitive standard cameras. In each IOI-positive case, the activated area was in accordance with the anatomical and neurophysiological location of the corresponding cortex. The technique was found to be very sensitive, and several negative influencing factors were identified. However, all possible artifacts seem to be controllable in the majority of the cases, and the IOI method could be well adapted for routine clinical use. Nevertheless, further systematic studies are needed to demonstrate the reliability and validity of the method.