Share ICCAS's longstanding experience and examine the need for further research in computer assisted surgery.

DORS 2016 has been certified by the national authority “Sächsische Landesärztekammer” with 57 CME credits. An application has also been made to the international authority EACCME® for CME accreditation and has been certified with 33 European CME Credits (ECMEC).

Motivation

Modern medical therapies are characterized by an increasing number of technological support, medical devices, information systems, imaging components or assistance systems. The need for research and development into new medical systems and networked applications for computer-assisted therapies is growing rapidly and new technologies have to be integrated into the clinical environment. Moreover, these systems need to be able to communicate and interact with each other and with the hospital’s IT environment.

The Digital Operating Room Summer School (DORS) encourages a new generation of young scientists from the fields of medicine, engineering and computer science to face the challenges resulting from the integration of new technologies for computer-assisted diagnosis and therapy.


Banner for DORS 2016

Description

DORS is primarily aimed at graduates, doctoral students, post-docs and senior scientists from research and industry with an interdisciplinary working background. The six-day course with an exciting program will comprise lectures, hands-on sessions and site visits to give an extensive overview of medical technology in digital operating rooms and interventional suites from different perspectives along with insights into current research projects and problems.

Clinical experts and users will explain their views and expectations regarding innovative computer-assisted technologies as well as the current state of the art in clinical practice and research. Both, successful developments and negative examples will be addressed. Moreover, the technical background of innovative infrastructure and technical standards will be examined, and various architectures, frameworks and communication technologies for computer assisted interventions are presented.

Program

Monday
12.09.2016
Tuesday
13.09.2016
Wednesday
14.09.2016
Thrusday
15.09.2016
Friday
16.09.2016
Saturday
17.09.2016
Day Topic COMPUTER ASSISTED SURGERY (CAS) ENDOSCOPY CHALLENGES IMAGE-GUIDED INTERVENTIONS CARS DAY: MODELS AND INTERDISCIPLINARITY SURGICAL ROBOTICS OR INFRASTRUCTURE AND FUTURE TECHNOLOGIES
8:00 - 10:00
Site visits
Welcome and Introduction Integrated-OR | Dep. of ENT surgery, Leipzig University Hospital Heart Interventions
(Thilo Noack, MD)
Anatomy Lab | Institute of Anatomy, University Leipzig Tele manipulator and robotics in urology
(Jens-Uwe Stolzenberg, MD)
Device Networking in the OR
(MSc. Max Rockstroh)
Image Guided Heart Rhythm Management
(Gerhard Hindricks, MD)
DaVinci Lab | Dep. of Urology Technical OR Standards
(Heinz Lemke, PhD)
10:00 - 12:00
Lectures Part I
CAS in ENT surgery
(Mathias Hofer, MD)
Introduction to Endoscopy
(Thomas Wittenberg, PhD)
ZEEGO Hybrid-OR | Heart Center Leipzig Surgical Workflow
(Pierre Jannin, PhD)
State of the art in surgical robotics
(Philipp Poignet, PhD)
The Future of Surgery from a Clinical Point of View
(Hubertus Feußner, MD)
CAS in Neurosurgery
(Dirk Lindner, MD)
Instrumentation for Flexible Endoscopy: Procedures and Technology
(Alberto Arezzo, MD)
MRI Cardiac Catheter Lab | Heart Center Leipzig Digital Patient Modeling
(Leonard Berliner, MD)
Demo-OR | ICCAS
Rigid Endoscopes in Visceral Surgery
(Ines Gockel, MD)
12:00 - 12:45 Lunch Lunch Lunch Lunch Lunch Lunch
12:45 - 13:45
Lectures Part II
CAS in ENT surgery
(Mathias Hofer, MD)
Endoscopy Intervention | University Hospital MRI-Ablation
(Mandy Grundmann, PhD)
Bridging the Radiology-Surgery Gap
(Ronald Schilling, PhD)
Bio inspired Robotics
(Arianna Menciassi, PhD)
Technical OR Standards
(MSc. Erik Schreiber)
MRI Interventions
(Harald Busse, PhD)
13:45 - 17:45

Hands-ons
(concurrent events)
CAS in Neurosurgery
(Dirk Lindner, MD)
Endoscopy in Visceral Surgery
(Ines Gockel, MD)
Image-Guided Interventions
(Michael Moche, MD)
Surgical Workflows
(MSc. Juliane Neumann)
Surgical Robotics I
(MSc. Richard Bieck)
13.45 - 15.15
Feedback and Farewell
Flexible Endoscopy
(Alberto Arezzo, MD)
Catheter Lab | Dep. of Radiology Digital Patient Modeling
(Dipl.-Inf. Mario Cypko)
Surgical Robotics II
(tba.)
Rigid Endoscopy
(Thomas Wittenberg, PhD)
Heart Interventions
(Thilo Noack, MD)
Image-Guided Interventions
(Michael Moche, MD)
Break Break Break Break Break Break Break
From 19:00 Social Event Social Event Social Event

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Special features

The educational concept of the summer school provides a strong interdisciplinary interaction of medical and technical aspects in a manner which is unique in the global technology landscape. Accordingly, the summer school will be organized in modules each devoted to a different topic and divided into lectures, visits and hands-on sessions.

This broad combination of teaching methods involving the close integration of theory and practice will give participants an intensive insight into many different aspects of computer-assisted surgery. Particular attention will be paid on achieving a sound balance between theoretical teaching and providing demonstrations of clinical practice.



Opinions and impressions about DORS 2015

A very intensive training course in a positive sense

Good balance between theoretical and practical topics

A great way to get an overview of the state of the art OR-technology


Hands-on workshop – computer-assisted technologies in ENT-surgery Hands-on workshop - computer-assisted technologies in neurosurgery.
Hands-on workshop at the ICCAS demo-OR Hands-on workshop at the ICCAS demo-OR.
Hands-on workshop – computer-assisted technologies in cardiovascular and image-guided interventions Hands-on workshop - computer-assisted technologies in cardiovascular and image-guided interventions.

General topics

Module 1 - Day topic: Computer-Assisted Surgery (CAS)

This module is dedicated to computer assisted ear-nose-throat-, neuro and maxillofacial surgery. After state-of-the-art presentations by medical experts, participants will be able to try out what they have learned in small groups during hands-on sessions. Various rapid prototyping models of anatomical structures will be available, allowing participants to practice surgical procedures on software and hardware simulators using real instruments and techniques. This will enable the understanding of clinical settings and its limitations in clinical practice. The planned visit to an integrated OR is part of the presentation to illustrate the current state of the art and demonstrate the different technologies and medical systems in practical use.


Venue of practical demonstrations:

  • Integrated operating room at the Department of Ear Nose and Throat Surgery at Leipzig University Hospital

Module details:

Dr. Mathias Hofer
Department of ENT-Surgery, University Hospital


more information about the lecture is coming soon.

Dr. Dirk Lindner
Department of Neurosurgery, University Hospital


Biosketch:

Since 2010 Dirk Lindner is consultant of Neurosurgery at the Department of Neurosurgery, University of Leipzig, Germany. He received his PhD in 2002. Between 2007 and 2008 he worked as a scientist at the Innovation Centre of Computer assisted Surgery (ICCAS). His scientific focus is on neurosurgical imaging, neuronavigation, scull base surgery and intraoperative ultrasound.

Aims and learning objectives:

In this lecture we will present Neurosurgery with specific questions to the research community. New developments, ideas and further work are demonstrated. Special focus is on the daily work and problems in the OR and the intraoperative imaging in Neurosurgery.

Practical work :

  • ultrasound: A specific phantom for calibration of intraoperative ultrasound is presented. Practical work and discussion with experienced neurosurgeon are possible.
  • craniotomy: The key to all parts of brain tumor operation is the optimal craniotomy. A specific phantom for operative preparation called “ surgical head phantom” is presented. Practical work and discussion with experienced neurosurgeon are possible.

Picture for Dr. Lindner
Milling device in action (Microspeed uni, Aesculap AG, Tuttlingen, Germany), accompanied by water flushing

Module 2 - Day topic: Endoscopy Challenges

The topic centers on the development of surgical assistance functions. Basic endoscopy-related technology will be explained as well as latest developments of new devices for flexible and rigid endoscopy, instrumentation and clinical procedures.


Venue of practical demonstrations:

  • Endoscopy Lab at Leipzig University Hospital

Module details:

Dr. Thomas Wittenberg
Fraunhofer Institute for Integrated Circuits IIS


Biosketch:

Thomas Wittenberg (*1964) studied Computer Science at the Christopher Newport University end the Erlangen University. From 1992 to 1993 he worked as software developer at the Fraunhofer Institute for Integrated Circuits IIS. From 1993 until 1999 he was researcher in the ENT clinics of the Erlangen University and received a PhD in 1998 in Engineering with a thesis about ‘Semiautomatic motion analysis of vocal folds using digital high-speed recordings’. From 1999 to 2009 he was head of the medical image-processing group at the Fraunhofer IIS. Currently he is deputy head and chief scientist of the Fraunhofer IIS image-processing and medical engineering department as well as head of the biomedical research group. From 2007 to 2011 he was visiting scientist at the Research Center for Computer-Integrated Surgical Systems and Technology (CISST) at The Johns-Hopkins University, USA. Since 1999, he has been a external lecturer at the University of Erlangen and has received the Venia Legendi in Informatics in 2011.

Summary:

Clinical progress in diagnostic and interventional Endoscopy (Gastroenterology) have been made possible in the past years based on new technological developments in the field of biomedical engineering. These new technological possibilities allow better diagnostics as well as more gentle and conservative (minimal invasive) interventions. In order to obtain a better understanding of diagnostic and therapeutic endoscopic equipment as well as the related clinical workflows and procedures, both, a theoretical understanding of the technological possibilities and advancements, as well as a practical hands-on experience of endoscopic procedures are necessary. Thus the goals of this lecture will be the presentation and hands-on experience of state of the art equipment and procedures with in the field of diagnostic and interventional endoscopy, as well as a view into with possible technological developments.


Picture for Dr. Wittenberg
Picture for Dr. Wittenberg

Aims and Learning Objectives:

  • Theory: To learn and understand the basic physical principles of endoscopy, to differentiate between various types of endoscopes, learn and know clinical applications and procedures of endoscopy, get to know future topics in endoscopy.
  • Practice: Phantom-based colonoscopy, MIS procedures on a laparoscopic training system (box trainer), panorama-cystoscopy.

Prof. Dr. Alberto Arezzo
Dip. di Scienze Chirurgiche Università di Torino


Biosketch:

Since 2014 Alberto Arezzo is Associate professor of surgery at the University of Turin, where, he is continuing the work at the Dept. of Surgical Sciences, Dir. Prof. Mario Morino, as Teacher of Emergency Surgery at the VI year of the School of Medicine, since his settlement. Similarly he is teacher and tutor of courses at the School of Surgery, such as Scientific English, Surgical Anatomy and Digestive Surgery. He is the Vice-Coordinator of the PhD Course in Technology Applied to Surgical Sciences, a 3 years international course training surgeons of different specialties to research activity in novel technology development. He is Faculty and Tutor of the II Level University Master course in Advanced Laparoscopy for MDs. He is Coordinator, Faculty and Tutor of the II Level University Master course in Operative Digestive Endoscopy for MDs. He is Coordinator, Faculty and Tutor of the I Level University Master course in Digestive Endoscopy for nurses.

Aims and learning objectives:

As new surgical techniques continue to evolve, the use of flexible endoscopy is increasingly important. Flexible endoscopy has long played a role in digestive surgery, and endoscopic procedures for benign and malignant digestive disease are increasingly replacing laparoscopic procedures. Teaching and learning cutting-edge endoscopic techniques represents a unique challenge to the surgeon. This course presents a unique opportunity for surgical residents, fellows and practicing general surgeons who may not already have the skills to perform flexible endoscopy to learn and test basic endoscopic skills required to form a foundation in the practice of flexible endoscopy.

Prof. Dr. Ines Gockel
Department of Visceral Surgery, University Hospital Leipzig


Biosketch:

Professor Dr. Ines Gockel, MBA, is the Director of the Department of Visceral, Transplant, Thoracic and Vascular Surgery at the University Hospital of Leipzig, Germany, since 10/2014. Before, she served as Associate Professor of Surgery at the Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University of Mainz, Germany. Professor Dr. Gockel’s clinical specialties include: surgical oncology, minimally-invasive surgery, surgery of the upper gastrointestinal tract, colorectal surgery, endocrine surgery and she has clinical experience in vascular and thoracic surgery, trauma surgery, surgical endoscopy and ultrasonography, proctology, intensive care medicine and emergency medicine. Professor Dr. Gockel’s additional qualifications include: MBA in International Hospital and Healthcare Management, Frankfurt School of Finance and Management and HÉC Montréal, Leadership Certificate from the St. Gallen Business School, St. Gallen, Switzerland.

Summary:

Exact staging of rectal cancer by rigid endoscopy is of utmost importance with respect to tumor location, tumor extension and surface characteristics. In addition, minimally-invasive transanal surgical resection techniques for distal rectal cancer, such as TransAnal Minimally Invasive Surgery (TAMIS), are emerging and represent promising options for total mesorectal excision (TME) with sphincter preserving high-quality functional outcome in complex cases. Prerequisite for manual dexterity and mastership of TAMIS in advanced rectal cancer as well as for TEM (Transanal Endoscopic Microsurgery) in early rectal cancer or large sessile polyps of the rectum is the correct setup of the system and anatomical training with respect to the anus and rectum. In a stepwise manner, diagnostic and therapeutic dissection instruments are introduced as basis to master the handling of instruments and to perform a safe procedure when starting the clinical application in all parts of the rectum and anus.


Picture for Dr. Gockel
Fig. 1: Instruments used for rigid rectoscopy and proctoscopy
Picture for Dr. Gockel
Fig. 2: TEM (Transanal Endoscopic Microsurgery)-Instruments
Picture for Dr. Gockel
Fig. 3: TEM (Transanal Endoscopic Microsurgery) specimen

Aims and learning objectives

  • Setup of the system and anatomical training with respect to anus, distal, middle and upper rectum
  • Focus on training of manual dexterity and mastership of the procedure
  • Stepwise awareness and handling of complex diagnostic and therapeutic ano-rectal procedures

Module 3 - Day topic: Image-Guided Interventions

This module will concentrate on cardiac surgery and image-guided interventions in radiology and cardiology as well as imaging techniques and smart catheters. These subjects support current developments in surgery to carry out increasingly complex operations through smaller and smaller incisions. Minimizing the impact on the patient in this way is of fundamental importance, especially for the growing number of elderly people. Stressful open heart surgery is being replaced by minimally invasive procedures such as heart valve replacement using a catheter, a procedure known as TAVI (transcatheter aortic valve implantation). The module includes a visit to one of Europe’s most advanced hybrid operating rooms in order to witness systems of computer assisted surgery at first hand.


Venues of practical demonstrations:

  • Catheter lab at the Department of Radiology at Leipzig University Hospital
  • Hybrid operating room at Heart Center Leipzig, University Hospital

Module details:

Dr. Harald F. Busse
Department of Diagnostic and Interventional Radiology, Leipzig University Hospital


Biosketch:

Harald Busse is currently heading the Imaging Research Group in the Department of Diagnostic and Interventional Radiology at Leipzig University Hospital. He studied Physics and Medicine at the University of Bonn and received his PhD degree in 1995. Between 1995 and 2000 he held scientific positions in the fields of Biomedical Engineering, Radiology and Information Technology at the University of Southern California (USC), Los Angeles, Düsseldorf University Hospital and Fraunhofer Institute of Applied Information Technology (FIT), Sankt Augustin. His research in Leipzig focuses on the clinical translation of medical enabling technologies, especially for the planning and control of minimally invasive procedures. In 2012, he coedited a book on Interventional MRI.

Summary:

Most image-guided procedures are carried out with the help of computed tomography (CT) or ultrasound (US) imaging because these modalities are widely available, work relatively fast and are performed in standard rooms. In addition, interventional MRI is generally confronted with long imaging times, strong magnetic fields and limited space in the narrow cylindrical bore. On the other hand, MRI is one of the most powerful diagnostic tools in modern medicine featuring a number of well-known advantages, such as a multitude of inherent tissue contrasts, high sensitivity to relevant functional information like molecular water diffusion or tissue perfusion, or the absence of ionizing radiation. Contraindications to X-ray techniques like CT or whenever findings cannot be properly identified by CT or US imaging, therefore represent clear indications for an MRI-guided approach. Since its inception in the mid-1990s, interventional MRI has experienced a wide array of technical developments, clinical settings and successful applications, practically in any body region, ranging from MRI-guided biopsies to completely MRI-controlled therapies. This session will provide an overview of clinical aspects and indications for MRI-guided interventions and demonstrate the setup, workflow and benefits of a virtual real-time navigation system for standard MRI systems (Figs. 1 and 2).


Picture for Dr. Busse
Figure 1 - MRI-guided liver biopsy in a closed-bore 1.5-T MRI using virtual real-time tracking of the needle.
Picture for Dr. Busse
Figure 2 - MRI-guided prostate biopsy in a closed-bore 3-T MRI using a modified commercial device with optical real-time tracking of the transrectal needle guide.

Aims and Learning Objectives:

  • Technical and safety considerations in an MRI environment
  • Technical and medical instrumentation for interventional MRI
  • Clinical aspects and indications for MRI-guided interventions
  • Setup, workflow and benefits of virtual real-time navigation for standard MRI systems

Dr. Thilo Noack
Heart Center Leipzig, University Hospital


more information is coming soon.

Dr. Michael Moche
Department of Diagnostic and Interventional Radiology, Leipzig University Hospital


Biosketch:

Michael Moche is head of the Section Interventional Radiology at the Department of Diagnostic and Interventional Radiology of the University Hospital Leipzig since 2007. His clinical work includes the whole spectrum of endovascular and non-vascular image guided interventions. After completing his residency in Diagnostic Radiology in 2004 he specialized in minimal invasive image guided therapy and was certified as an instructor for Interventional Radiology according the German Society of Interventional Radiology (DeGIR). His main research topics involve MR-guided interventions and the development of planning and simulation strategies of minimal invasive cancer treatment. He is central medical partner of several German (BMBF - MobiGuide) and European (FP7 - IMPPACT, GoSmart, ClinicIMPPACT) research projects. He is reviewer for the Deutsche Forschungsgesellschaft and for a number of International Journals and member of the German and European Society of Radiology (DRG, ESR) and the German and European Society of Interventional Radiology (DeGIR, CIRSE).

Aims and learning objectives:

  • Description of requirements and use cases for technical systems in image guided interventions
  • Knowledge about state-of-the-art tools and techniques
  • understanding of operation principles of image-guided systems
  • experience of clinical challenges that need to be considered before and while using the technology

Dr. Mandy Grundmann
Forschungscampus STIMULATE


Biosketch:

Mandy Grundmann is the group leader of the research group “MR tools” within the Forschungscampus STIMULATE at the Otto-von-Guericke-University Magdeburg, Germany. Dr. Grundmann has a degree in electrical engineering and has recently earned her Ph.D. Her dissertation was primarily addressed to resonant marker design for instrument visualization during interventional magnetic resonance imaging. The current work of her research group focuses on the development of an optimized patient access for wide-bore MRI units as well as new concepts of dedicated interventional MRI receive coils.

Summary:

For the treatment of liver metastasis a two-step procedure is beneficial. At first, a transarterial chemoembolization (TACE) will be performed using C-arm CT. This pro-cedure affects the tissue perfusion within the metastasis and has a positive impact on the subsequent MRI guided ablation. For the intervention within the wide-bore MRI a holistic treatment approach is aimed. Firstly, a preoperative treatment planning is done in order to determine the optimized position of the ablation applicator. This applicator is then placed into the liver involving real-time MR imaging, an optical Moi-ré Phase tracking system, interventional MRI coils, an interventional patient table and an augmented reality system. The actual needle position is correlated with the opti-mized needle position determined by the planning system. This enables a recalculation of the expected ablation zone. The tissue will be heated using an MRI suited microwave ablation system while monitoring the procedure MR thermometry. The recorded temperature map is transmitted to the ablation planning system in order to update the planning and enable an online feedback of the intervention.


Picture for Dr. Grundmann

Aims and learning objectives:

  • Showing a concept development for an MRI guided ablation of liver metastasis within a wide-bore MRI
  • Showing essential components for the aimed intervention, such as optimized patient access, MRI compatible ablation system, dedicated interventional MRI coils, augmented reality system, ablation planning system, tracking and therapy monitoring

Prof. Dr. Gerhard Hindricks
Heart Center Leipzig, University Hospital


Biosketch:

Professor Gerhard Hindricks was born in Rheine/Westphalia, Germany. He attended the Westfälische Wilhelms University in Münster where he completed his medical education. After graduation he worked under Professor Günter Breithardt at the Department of Cardiology and Angiology at the University of Münster (1989 – 1998). He is specialist for Internal Medicine and Cardiology. Since April 1998, he works as co-director (initially) and then director of the Department of Electrophysiology at the Heart Center of the University of Leipzig, which is one of the biggest Electrophysiology Departments worldwide. Since 2005 he is a Professor of Medicine at the University of Leipzig. His particular scientific areas of interest are cardiac electrophysiology, catheter ablation, cardiac pacing, atrial fibrillation, ventricular tachycardia, and sudden cardiac death. He has more than 400 publications in German and international journals, monographies and textbooks. He is Deputy Editor of the European Heart Journal and Reviewer for numerous high-impact medical journals. Prof. Hindricks is a very active member of the German and of the European Society of Cardiology. Since June 2015, he is the current president of the European Heart Rhythm Association. He is also General Manager of the Leipzig Heart Institute, a major Research and Development Project in Saxony, Germany.

Module 4 - CARS-Day: Models and Crossdisciplinarity

Computer-assisted radiology surgery relies substantially on computerized models of surgical processes and patients. The module will give insights to the designed applications of these models as well as interdisciplinary model application. The module is supported by an anatomy lab tour for visiting the model references.


Venue of practical demonstrations:

  • Anatomy lab at University of Leipzig’s Institute of Anatomy

Module details:

Prof. PhD Pierre Jannin
LTSI, Inserm UMR 1099 - Université de Rennes 1


Biosketch:

Pierre Jannin is an INSERM Research Director at the Medical School of the University of Rennes (France). He is the head of the MediCIS research group from both UMR 1099 LTSI, Inserm research institute and University of Rennes. He was awarded the PhD degree from the University of Rennes in 1988 on multimodal 3D imaging in neurosurgery and the “Habilitation” (HDR) from the University of Rennes in 2005 on information and knowledge assisted neurosurgery. He has about 30 year experience in designing and developing computer assisted surgery systems. His research topics include image-guided surgery, multimodal imaging data fusion, surgical data science, augmented reality, modeling of surgical procedures and processes, study of surgical expertize, surgical training and validation methodology in medical image processing. The main clinical application areas include functional neurosurgery and surgery of low-grade tumors in central areas. He authored or co-authored more than 60 peer-reviewed international journal papers and more than 80 international conferences long papers. He is the President of the International Society of Computer Aided Surgery (ISCAS). He is board member of the MICCAI society. He is senior member of the SPIE society. He is Deputy Editor for the International Journal of Computer Assisted Radiology and Surgery. He is member of the Editorial Board of the Journal of Computer Aided Surgery. He is acted as associate editor and reviewer for several journals (e.g., IEEE TMI, MedIA, IJCARS, Neuroimage, Yearbook of Medical Informatics). He is member of several Organizing and Program Committees of international conferences, such as MICCAI, CARS, SPIE Medical Imaging, and MMVR. He is Co-General Chair and founder of IPCAI conferences from 2010.

Prof. MD Leonard Berliner
Clinical Assistant Professor of Radiology, Weill Cornell Medical College / Chief of Interventional Radiology, Department of Radiology, NY Methodist Hospital


Biosketch:

Leonard Berliner is Chief of Interventional Radiology at New York Methodist Hospital in Brooklyn, New York and Clinical Assistant Professor of Radiology. Weill Cornell Medical College of Cornell University, New York. He received his Medical Degree from Downstate Medical Center /State University of New York (1976) and performed his residency and fellowship training in abdominal imaging and vascular-interventional radiology at New York University Medical Center (1977-1981), serving as Chief Resident in 1980 and 1981. In addition to full-time clinical practice vascular and interventional radiology, Dr. Berliner has authored/co-authored over 90 articles, book chapters, and conference presentations on aspects of radiology and, most recently, patient modelling and personalised medicine. Current research is related to the role of information and communication technology in predictive, preventive and personalised medicine. Dr. Berliner is a member of the Society of Interventional Radiology. He has served on the editorial board for the EPMA Journal and as a Deputy Editor of the International Journal of Computer Assisted Radiology and Surgery. He is a Fellow of the European Association for Predictive, Preventive and Personalised Medicine. He currently serves as clinical co-chairman of the Workgroup 24: DICOM in Surgery of the DICOM Standards Committee and is a member of the Organizing Committee of the Computer Assisted Radiology and Surgery (CARS) meetings (http://www.cars-int.org/).

Summary:

Medical modeling may be as old as mankind itself. Over the centuries, man has looked at health and disease from different points of view which, during each historical age, have been limited by his overall understanding of reality. Life and death; anatomy and physiology; medicine and surgery have been understood within an evolving frame of reference fueled by an ever-expanding fund of knowledge. Medical models, both primitive and sophisticated, are representations of the human organism, and may be mental, physical, and/or symbolic -- graphical, mathematical, virtual. Throughout history, the various forms of medical models created by man have not necessarily been abandoned as new forms have been introduced, but, in general, have become more refined and have been incorporated into an overall view of health and disease. What is new today is an attempt to formalize medical modeling in line with current scientific and mathematical concepts and research. The resulting Digital Patient Model is capable of incorporating virtually all known facets of the human organism in a form amenable to computer analysis and processing. Our ability to create accurate and predictive medical models is predominantly restricted by limitations in our knowledge-base, and, our ability to create, generate and understand effective symbolic representations. In addition, total medical predictability may also be limited by naturally occurring, random physiological forces; those same forces, even on a molecular level, that ensure adaptability and evolution of living things. Regardless of any limitations, Digital Patient Models provide an effective means of understanding and influencing human health and disease. A properly constructed model can provide a flexible tool for addressing specific medical needs and applications, especially with respect to Personalized, Predictive and Preventive healthcare. Digital Patient Models may directly contribute to the acquisition of medical knowledge when features capable of machine learning are incorporated. This presentation will first provide a brief history of medical modeling with the intention of providing perspective and a frame of reference. Medical modeling will be viewed as a process in evolution and help us understand the many ways we look at the human organism today. Recent efforts to create a Digital Patient Model for hepatocellular carcinoma will then be reviewed. It will be shown how Information Entities derived from many different sub-types of medical models, both old and new, are utilized to construct a comprehensive and modern, Digital Patient Model.

Aims and learning objectives:

  • A perspective for Digital Patient Models, through a review of the development of medical modeling through the ages, will be provided.
  • It will be demonstrated how medical modeling today has evolved into a digital format amenable to computer analysis and processing.
  • Strengths and limitations of Digital Patient Models, especially with respect to predictive and machine learning capabilities will be reviewed.
  • A Digital Patient Model for hepatocellular cancer will be presented and analyzed.
  • The impact of Digital Patient Models on Personalized healthcare and future challenges will be discussed.

Dr. Ronald Schilling


Biosketch:

Ronald B. Schilling has experience ranging from research (team that developed CMOS integrated circuits), business development (integrated circuits), marketing (microprocessors), strategic planning (medical imaging), international (1st CT in China), general management (CT, MRI, neurovascular), CEO (interactive virtual reality), investment banking and venture capital. In all of the above, the common theme has been “thinking outside the box.” Essentially, using the elements to create a better way of achieving an opportunity. For example, using interactive virtual reality (IVR) as an approach for “Bridging the Radiology-Surgery Gap.” This is done by recognizing that IVR creates a Visualization Driven Communication Vehicle between Radiology and Surgery. Experience in the above areas has led to a course at Stanford, “Tools for Strategic Management.” The idea is to select the “right tool for the right job.” This approach allows teams to create the best solution since their ability to communicate strategically is significantly increased.

Aims and learning objectives

“Bridging the Radiology-Surgery Gap,” is an example of using Interactive Virtual Reality (IVR) as an approach to creating a Visual Communication tool. Radiologist has stated that with IVR she can speak more intelligently with Surgeons. A Surgeon has stated that when opening up patients, one never sees a 2D view. Thinking strategically about these points leads one to think about creating the bridge. This course will discuss the concepts bringing the above elements together.

Module 5 - Day topic: Surgical Robotics

This module deals with the use of robots as surgical assistance systems in medicine. Clinical applications of telemanipulators and robotic systems will be demonstrated. Furthermore, the participants will practice the design and implementation of a robot-assisted surgical procedure.


Venue of practical demonstrations:

  • tba

Module details:

Prof. Dr. Jens-Uwe Stolzenberg
University of Leipzig, Department of Urology


Biosketch:

  • 2014 - Honorary Fellowship of Royal College of Physicians and Surgeons of Glasgow
  • 2012 - Honorary Member of Dutch Urological Association and Honorary Section Endourology of Polish Urological Association
  • 2011 - St. Paul’s medal of British Association of Urological Surgeons
  • 2011 - Honorary Member of Hungarian Society of Urology
  • since 2010 - Chairman of the board of Section of of Laparoscopy and Robot-assisted Surgery of the German Association of Urology
  • 2010 - Honorary member of Georgian Society of Urology
  • 2010 - Fellowship by election, Royal College of Surgeons of England
  • 2007 - Fellowship ad hominem, Royal College of Surgeons of Edinburgh
  • since 2007 - Professor and Director, Department of Urology, University of Leipzig
  • 2003 - Associate Professor of Urology
  • 2003 - Defence of Habilitation (equivalent to PhD), Title: "Comparative anatomy of the male and female dog and male guinea-pig and human lower urinary tract: histomorphology and three-dimensional reconstruction”
  • since 2002 - Chairman of International Urological Training Centre of Laparoscopy and Robotic-assisted Surgery
  • 1999 - Consultant, Department of Urology, University of Leipzig
  • 1993 – 1999 - Resident and Senior Resident, Department of Urology and Department of Surgery, University of Leipzig
  • 1992 – 1993 - Awarded German Scientific Society ("Deutsche Forschungsgemeinschaft") grant to attend for scientific studies (6 months) at the College of Medicine, Department of Pharmacology in Saskatoon (Canada) in neurophysiology, “Pharmacological characteristics of potassium-induced, glycogenolysis in astrocytes”
  • 1992 - Medical Degree, received from the University of Leipzig/ Germany
  • 1992 - Defence of Dissertation A Title: “Rabbit retinal Müller cells in cell culture” (Doctorate thesis)
  • 1990 - Defence of Diploma (equivalent to Masters degree): Title: “Size and density of glial and neuronal cells within the cerebral neocortex of various insectivorian species”
  • 1985 – 1992 - Medical school, University of Leipzig

Prof. Dr. Philippe Poignet
Director of the LIRMM


Biosketch:

Since 2007 Philippe Poignet is Full professor in Electrical Engineering at the Technical Institute of Montpellier (IUT), University of Montpellier. As head of the research team DEXTER (design and manipulation robot control) within the LIRMM Robotics department from 2004 to 2011, he is now responsible for the Robotics department. His research focuses on robotics. He is (or was) scientific leader in several national (ANR TREMOR 2007-2011 ANR USComp 2009-2012 ANR ROBACUS 2012 to -2014) and European projects (FP6AccuRobAs 2006 to -2009, FP7 Arachnees 2008- -2012) within LIRMM. He is also co-organizer of a summer school in surgical robotics organized every two years since 2003.

Aims and learning objectives:

  • During the talk, we will present the features of a large panel of surgical robots through the analysis of surgical tasks from the engineering point of view and the provided robotic solutions.
  • In addition, we will discuss the added values and limitations of these robots with respect to manual procedures.
  • Finally, we will highlight some future trends and technical challenges related to the development of new surgical procedures."

Prof. PhD Arianna Menciassi
Scuola Superiore Sant’Anna, The BioRobotics Institute


Learning objectives:

  • Participants will learn a methodology for extracting design rules for medical devices from nature
  • Participants will understand how bio-inspired design can help in innovating traditional devices.
  • Participants will learn the fundamental problems and features for targeting therapy: how bringing the therapy where and when requested in remote areas of the human body.
  • Participants will be provided with examples of bio-inspired tools and miniature tools for surgery and therapy.

A bio-inspired manipulator for minimally invasive surgery
A soft-tether capsule for targeted therapy and diagnosis

Short summary:

Robotic manipulators have been introduced for the first time in surgery in 1985, when a Puma 560 was used by Kwoh et al. for performing neurosurgical biopsies with high precision. After that milestone, robots and robotic technologies have gained an increasingly important role in surgery, thanks to the accuracy and repeatability they could add to surgical tasks. The introduction of robots in surgical rooms have also entailed important issues in terms of cost, safety, reliability, which are lively debated even today. From the original task of increasing accuracy and repeatability, robots today are asked to do more: they should be un-intrusive and safe, they should perform better some tasks and they should reach areas normally not reachable by traditional surgical solutions. The quest for minimally invasiveness led to medical robots with a more friendly design, where bio-inspiration plays a major role. The quest for miniaturization and natural access led to the development of diagnostic and surgical tools to be delivered with an endoluminal and transluminal approach, and to be controlled by innovative remote operation schemes from outside. The quest for targeted therapy has recently opened new opportunities for robots, which are used more and more as controllers for the delivery of drugs collected by nanobiotech vectors. This talk aims to present the above mentioned trends, with the support of specific examples coming from the speaker experience and her collaboration network.

Biosketch:

Arianna Menciassi is Professor of Biomedical Robotics at Scuola Superiore Sant’Anna (SSSA) and team leader of the “Surgical Robotics and Allied Technologies” group at The BioRobotics Institute. For some months between 2013 and 2014, she was Visiting Professor at the Ecole Nationale Superieure de Mecaniques et des Microtechniques (ENSMM) of Besancon (France), in the FEMTO Institute, and Visiting Professor at the ISIR Institute at the Pierre and Marie Curie University in Paris. She has considerable experience in leading interdisciplinary teams toward successful outcomes. In terms of education, she served as preceptor to 10 postdoctoral associates, 15 PhD students and 40 graduate degree recipients. Her main research interests involve biomedical robotics, bio-hybrid systems, microsystem technology, nanotechnology and micromechatronics, with a special attention to the synergy between robot- assisted therapy and micro-nano-biotechnology-related solutions. She carries on an important activity of scientific management of several projects, European and extra-European, thus implying many collaborations abroad and an intense research activity. She is co-author of more than 270 scientific publications (more than 130 on ISI journals) and 6 book chapters on biomedical robots/devices and microtechnology. She is also inventor of 25 patents, national and international. She served in the Editorial Board of the IEEE-ASME Trans. on Mechatronics and she is now Topic Editor in Medical Robotics of the International Journal of Advanced Robotic Systems; she is Co-Chair of the IEEE Technical Committee on Surgical Robotics, she is the Nanotechnology Technical Committee representative of the steering committee of the IEEE Transactions on Nanobioscience.

Module 6 - Day topic: OR – Infrastructures and Future Technologies

Medical device networks, software protocols and communication will play a critical role in future medicine. This module will set the foundations for the understanding of future technical infrastructures and will present latest results and technologies for networked operating rooms. Finally, leading clinical experts will present their impressions on the future of surgery.

Networking in the operating room will be demonstrated and illustrated by means of the findings of the BMBF German Ministry of Education and Research flagship project OR-NET. A hands-on session on surgical robotics in the fully networked operating room at ICCAS completes the practical part.


Venue of practical demonstrations:

  • Fully networked operating room at ICCAS

Module details:

Prof. Dr. Heinz U. Lemke
International Foundation for Computer Assisted Radiology and Surgery (IFCARS)


Biosketch:

Heinz Lemke is professor of Computer Science and teaches and supervises research on Computer Assisted Medicine at the Technical University of Berlin. He is also Research Professor of Radiology at the University of Southern California and senior advisor on research strategies at the Innovation Center Computer Assisted Surgery. Heinz U. Lemke was educated in Computer Science at the Universities of London and Cambridge between 1965 and 1970, and in pathology 1981-1982 at the University of Cambridge. He received his PhD in Computer Graphics and Computer Aided Design at the University of Cambridge in 1971. From 1974-2006 he was professor of Computer Graphics and Computer Assisted Medicine at the Technical University of Berlin and Dean of the Faculty of Informatics 1979-1981. Since 1983 Heinz Lemke is the organizer of the congress series Computer Assisted Radiology and Surgery (CARS), editor-in-chief of the International Journal of CARS and executive director of the International Foundation for CARS. Heinz Lemke has been a consultant to many major medical technology companies and health care institutions and was co-founder and board member of professional societies such as ISCAS, EuroPACS, CURAC, EPMA and SCAR. During the last 25 years he was Visiting Professor at universities in USA, Japan, China, Egypt and Switzerland. Heinz Lemke is a founding member of the Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig and has been actively engaged in mathematical and IT modelling methods for patients and process modelling for diagnosis and therapy. This was based on his earlier work on the development of patient-specific modelling, computer assisted radiology and surgery, PACS, computer graphics, medical workstations and model management systems, which have been published in about 150 papers and 45 edited books.

Prof. Dr. Hubertus Feußner
Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München


Biosketch:

  • 2016 - Co-Editor Innovative Surgical Sciences (ISS)
  • 2015 - Deputy Editor IJCARS
  • 2013 - Board member of the German Society for computer and roboter assisted surgery (CURAC)
  • 2013 - Chairman of the Section for Computer and telematic assisted Surgery (CTAC) of the German Surgical Society (DGCH)
  • 1999 - Associate Professor of Surgery Chairman of the Research Institute for Minimally Invasive Interdisciplinary Therapeutic Intervention
  • 1989 - Board certification General Surgery
  • 1985 - Co-founder of the working group Dysphagia Munich
  • 1983 - Internship, Department of Surgery, Klinikum rechts der Isar der Technischen Universität München (Prof. Siewert)
  • 1981 - Internship, Department of General and Vascular Surgery, Heinz Kalk Hospital, Bad Kissingen (Prof. K.J. Paquet) Internship, Surgical Department St. Helier’s Hospital, London, England
  • 1979 - Internship, Department of Urology, Kassel Medical Center (Prof. Dr. Melchior)
  • 1973-1979 - Medical school at Philipps Universität Marburg

Summary:

Surgery today is located in a very competitive environment. Accordingly, this discipline is forced to become increasingly more innovative in order to be able to offer attractive therapeutic options to the patients. Less invasive therapeutic alternatives are continuously developed by interventional endoscopy and interventional radiology. Some parts of the surgical domain will be even lost to medical treatment. If surgery is willing to survive, it has to optimize the outcome and, simultaneously, to reduce the surgical trauma and the expenses. These contradicting aims can only be reached by the combined use of cyber-physical systems. Digitalisation of surgery may be denominated as “surgery 4.0”. This process will be primarily focussed on the surgical operation room which is the “profit centre” of any surgical unit. The aim is to transform it into a “collaborative environment”. Based upon a multitude of continuous real time data, a support system should be capable to interpret the actual situation (context sensitivity) and to predict the next steps required. In addition to the necessary medical and organizational structured knowledge which has to be provided before, the system should be able to learn from repeated procedures. Thus, it should offer active assistance to the surgical team to use the technical environment adequately, to smoothen the workflow, to avoid mistakes and to improve the safety level. To reach this goal, some preconditions have still to be met: Comprehensive systems integration, the development of surgical and patient models and a perfect communication not only between the devices and instruments but also with the human user. Making this vision mature for regular clinical care is challenging but first promising approaches have already been developed.

Aims and learning objectives:

  • showing development of the digitalization of surgery (surgery 4.0)
  • showing development of surgical and patient models and communication between devices and human user

Conditions of participation


Application is open to:

  • MD-, M.Sc. and Ph.D. students
  • postdoctoral fellows
  • young and senior researchers in science or industry
  • industrial professionals

from the fields of

  • medicine
  • medical/health/bio informatics
  • medical/health/bio engineering.

To guarantee individual support in small working groups the number of participants is limited to 40. Application for all days (modules) and for single days (individual modules) of DORS 2016 is possible.

If you have further questions please send an E-Mail to: dors@iccas.de

Costs

Early bird registration is open until 30.06.2016
TYPE Early-bird Regular per module
M.Sc./ PhD students 600 € 700 € 150 €
Academic position 750 € 850 € 150 €
other participants 850 € 850 € 150 €
(all prices include VAT, lunch, coffee breaks and working materials)

VolkswagenStiftung supports ICCAS’s Digital Operating Room Summer School – apply now!

This year’s Digital Operating Room Summer School (DORS) is funded by VW-Stiftung. You can now apply for the refund of accommodation expenses and travel costs. (No refund of participation fees!)

Requirements:
  1. Register for DORS 2016 on: www.iccas.de/dors.
  2. After registration send immediately your CV and letter of motivation (max. 250 words) to: dors@iccas.de

The DORS-committee will make a fast choice on the basis of all documents.

Venues

The school will be held in the lecture hall of the Center for Biotechnology and Biomedicine (BBZ) Leipzig (Deutscher Platz 5, Leipzig) and at the premesis of ICCAS (Semmelweisstrasse 14, Leipzig).

BBZ Leipzig Exterior (BBZ)

BBZ Leipzig Interior (BBZ)

ICCAS at Semmelweisstrasse

Locations

Leipzig is always worth a visit. The city of Linden, is now over a thousand years old and Germany's fastest growing city. Famous events in European history such as the Battle of Leipzig in 1813 and the Peaceful Revolution in 1989 are associated with it. Today, Leipzig is a key center of commerce, culture and learning. Moreover, the city has become an attractive business location in Central Germany. It focuses on expanding industries such as biotech and biomedical engineering. The result is an extended landscape of higher education and the establishment of important research centers. After work a guided tour through Leipzig city center or a pub visit are planned to better get to know the location and your international colleagues.

We look forward to welcoming you!

The scientific committee

Head of the committee

Prof. Thomas Neumuth, PhD | ICCAS vice director
E-Mail: thomas.neumuth@medizin.uni-leipzig.de

Prof. Andreas Melzer, MD, DDS | ICCAS director
E-Mail: andreas.melzer@medizin.uni-leipzig.de

Contact

Event organization
Universität Leipzig // Faculty of Medicine
Innovation Center Computer Assisted Surgery (ICCAS)
Frederik Krabbes

Phone: 0341 / 97-12032
Fax: +49( (0) 341 / 97 12009
E-Mail: dors@iccas.de


Funded by:
VW Stiftung Logo

Supported by:
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IFCARS Logo
GMDS Logo
SMIT Logo
CURAC Logo
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