Alfredo Illanes

SURAG Medical

We propose a new and complementary approach to image guidance for monitoring medical interventional devices (MID) with human tissue interaction and surgery augmentation by acquiring acoustic emission data from the proximal end of the MID outside the patient to extract dynamical characteristics of the interaction between the distal tip and the tissu...

Most surgeons are skeptical as to the feasibility of autonomous actions in surgery. Interestingly, many examples of autonomous actions already exist and have been around for years. Since the beginning of this millennium, the field of artificial intelligence (AI) has grown exponentially with the development of machine learning (ML), deep learning (D...

Purpose Percutaneous needle insertion is one of the most common minimally invasive procedures. The clinician’s experience and medical imaging support are essential to the procedure’s safety. However, imaging comes with inaccuracies due to artifacts, and therefore sensor-based solutions were proposed to improve accuracy. However, sensors are usually...

The direct tactile assessment of surface textures during palpation is an essential component of open surgery that is impeded in minimally invasive and robot-assisted surgery. When indirectly palpating with a surgical instrument, the structural vibrations from this interaction contain tactile information that can be extracted and analysed. This stud...

Background: The shift towards minimally invasive surgery is associated with a significant reduction of tactile information available to the surgeon, with compensation strategies ranging from vision-based techniques to the integration of sensing concepts into surgical instruments. Tactile information is vital for palpation tasks such as the differe...

This article provides a comprehensive analysis of the feature extraction methods applied to vibro-acoustic signals (VA signals) in the context of robot-assisted interventions. The primary objective is to extract valuable information from these signals to understand tissue behaviour better and build upon prior research. This study is divided into th...

The endoscopic examination of subepithelial vascular patterns within the vocal fold is crucial for clinicians seeking to distinguish between benign lesions and laryngeal cancer. Among innovative techniques, Contact Endoscopy combined with Narrow Band Imaging (CE-NBI) offers real-time visualization of these vascular structures. Despite the advent of...

Image-guided and minimally invasive procedures still require confirmation on having reached a target. Intraoperative imaging is not always sufficient or conclusive as it comes with artifacts that can come with a certain amount of ambiguity and inaccurate location information. As an alternative to imaging, we want to explore sounds produced by the b...

The overall complication rate during laparoscopic access is estimated to be as high as 14 %. Surgeons have to rely heavily on their experience and haptic perception while inserting the Veress needle or a trocar into the peritoneal cavity. Surgical Audio Guidance (SURAG) is a promising alternative to current techniques. It acquires instrument-born v...

This paper presents the use of vibro-acoustic sensing to augment laparoscopic surgery procedures by analyzing the signals produced during cutting and palpation tasks on various tissue samples. Vibro-acoustic signals were acquired during an experiment on a dedicated phantom covered in dense foam, where three trocars were inserted into the phantom to...

Background: Thyroid nodules are very common. In most cases, they are benign, but they can be malignant in a low percentage of cases. The accurate assessment of these nodules is critical to choosing the next diagnostic steps and potential treatment. Ultrasound (US) imaging, the primary modality for assessing these nodules, can lack objectivity due...

What were our product development goals in medical imaging and image-guided therapies in recent decades [...]

This paper presents the proof-of-concept study of an adaptor allowing the combination of a gamma probe with ultrasound (US) imaging, intending to improve the detectability of sentinel lymph nodes (SLNs). The performance of the adaptor in US imaging, in terms of depth of penetration and distance accuracy, and gamma scanning, in terms of sensitivity...

In previous work, we demonstrated the potential of blood flow sounds for biometric authentication acquired by a custom-built auscultation device. For this purpose, we calculated the frequency spectrum for each cardiac cycle represented within the measurements based on continuous wavelet transform. The resulting spectral images were used to train a...

Ultrasound (US) imaging is used for the diagnosis and also evaluation of thyroid nodules. A Thyroid Imaging Reporting and Data System (TIRADS) is used for the risk stratification of thyroid nodules through US images. The composition of thyroid nodules plays an important role in the risk-stratification process. The percentages of cystic and solid co...

Minimal-invasive procedures come with significant advantages for the patient. They also come with problems as the navigation/guidance of the devices to a target location is either based on pre-operatively acquired images and then performed free-hand or is accompanied by intraoperative imaging such as MRI or CT that is expensive, complicated and pro...

Creating surgical access is a critical step in laparoscopic surgery. Surgeons have to insert a sharp instrument such as the Veress needle or a trocar into the patient’s abdomen until the peritoneal cavity is reached. They solely rely on their experience and distorted tactile feedback in that process, leading to a complication rate as high as 14% of...

This is a review focused on advances and current limitations of computer vision (CV) and how CV can help us obtain to more autonomous actions in surgery. It is a follow-up article to one that we previously published in Sensors entitled, "Artificial Intelligence Surgery: How Do We Get to Autonomous Actions in Surgery?" As opposed to that article tha...

This white paper documents the consensus opinion of the expert members of the Editorial Board of Artificial Intelligence Surgery regarding the definitions of artificial intelligence and autonomy in regards to surgery and how the digital evolution of surgery is interrelated with the various forms of robotic-assisted surgery. It was derived from a se...

One of the most applied imaging methods in medicine is endoscopy. A highly specialized image modality has been developed since the first modern endoscope, the “Lichtleiter” of Bozzini was introduced in the early 19th century. Multiple medical disciplines use endoscopy for diagnostics or to visualize and support therapeutic procedures. Therefore, th...

(1) Background: Contact Endoscopy (CE) and Narrow Band Imaging (NBI) are optical imaging modalities that can provide enhanced and magnified visualization of the superficial vascular networks in the laryngeal mucosa. The similarity of vascular structures between benign and malignant lesions causes a challenge in the visual assessment of CE-NBI image...

Farmed fish are affected by environmental variability and farming practices, such as farming density, feed composition and feeding regime. We developed four feeding activity indices to assess how environmental variability, ration size and feeding time lags affect the feeding activity of farmed Salmo salar. We used a real-time video monitoring syste...

Treating of cancer is an important task e.g. in the liver which is one of the solid organs with high incident of tumor. Due to the technical improvement on biomedical systems and minimal invasive therapies currently microwave ablation (MWA) therapy as an invasive minimal therapy gets a lot of attention for destroying the cancer cells in its locatio...

Auscultation methods allow the non-invasive diagnosis of pathological conditions (e.g., of the lung, heart or blood vessels) based on sounds that the body produces (e.g., breathing, heartbeat, swallowing or the blood flow). Through regular homebased examinations and Big Data combined with Machine learning techniques like Deep Learning, these could...

About 50 % of complications during laparoscopy occur when surgical access is created. The Veress needle and proposed technical alternatives do not provide reliable information to support the surgeons in guiding the needle, or the feedback is not clearly perceivable. Based on acoustic emissions, Surgical Audio Guidance (SURAG) proposes a non-invasiv...

Ultrasound (US) imaging is used as a preliminary diagnostic tool for the detection, risk-stratification and classification of thyroid nodules. In order to perform the risk stratification of nodules in US images physicians first need to effectively detect the nodules. This process is affected due to the presence of inter-observer and intra-observer...

Auscultation methods allow a non-invasive diagnosis of cardiovascular diseases like atherosclerosis based on blood flow sounds of the carotid arteries. Since this process is highly dependent on the clinician’s experience, it is of great interest to develop automated data processing techniques for objective assessment. We have recently proposed a co...

Background: Biometric sensing is a security method for protecting information and property. State-of-the-art biometric traits are behavioral and physiological in nature. However, they are vulnerable to tampering and forgery. Methods: The proposed approach uses blood flow sounds in the carotid artery as a source of biometric information. A handhe...

Introduction According to a study conducted in 2019, the German health care industry is suffering under severe personnel shortage with a lack of over 50.000 medical care workers, operating room nurses, and surgical technicians. This need will become worse in the upcoming decades. Automatization of highly standardized procedures could be a promising...

Under-staffing of nurses is a significant problem in most countries. It is expected to rise in the coming years, making it challenging to perform crucial tasks like assessing a patient's condition, assisting the surgeon in medical procedures, catheterization and Blood Transfusion etc., Automation of some essential tasks would be a viable idea to ov...

Background: Feature extraction is an essential part of a Computer-Aided Diagnosis (CAD) system. It is usually preceded by a pre-processing step and followed by image classification. Usually, a large number of features is needed to end up with the desired classification results. In this work, we propose a novel approach for texture feature extracti...

Longitudinal and perpendicular changes in the blood vessels of the vocal fold have been related to the advancement from benign to malignant laryngeal cancer stages. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) provides intraoperative realtime visualization of vascular pattern in Larynx. The evaluation of these vascular pa...

Arthroscopic surgery is a technically challenging but common minimally invasive procedure with a long learning curve and a high incidence of iatrogenic damage. These damages can occur due to the lack of feedback and supplementary information regarding tissue-instrument-contact during surgery. Deliberately performed interactions can be used however...

In robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visua...

This work focuses on investigating an optimal foetal heart rate (FHR) signal segment to be considered for automatic cardiotocographic (CTG) classification. The main idea is to evaluate a set of signal segments of different length and location based on their classification performance. For this purpose, we employ a feature extraction operation based...

Introduction: Atherosclerotic diseases of the carotid are a primary cause of cerebrovascular events such as stroke. For the diagnosis and monitoring angiography, ultrasound- or magnetic resonance-based imaging is used which requires costly hardware. In contrast, the auscultation of carotid sounds and screening for bruits - audible patterns related...

The classification of thyroid nodules using ultrasound (US) imaging is done using the Thyroid Imaging Reporting and Data System (TIRADS) guidelines that classify nodules based on visual and textural characteristics. These are composition, shape, size, echogenicity, calcifications, margins, and vascularity. This work aims to reduce subjectivity in t...

proof of concept in vitro study

Accurate needle placement is highly relevant for puncture of anatomical structures. The clinician’s experience and medical imaging are essential to complete these procedures safely. However, imaging may come with inaccuracies due to image artifacts. Sensor-based solutions have been proposed for acquiring additional guidance information. These senso...

Photodynamic diagnostic (PDD) is an optical enhancement option for the endoscope to support the detection of cancer, for example in the bladder. In real application PDD efficiency suffers due to the complex accumulation of the photosensitizing drug inside the tumor and the associated processes of heme syntheses to create the fluorescent components...

During thermal ablation in a target tissue the information about temperature is crucial for decision making of successful therapy. An observable temporal and spatial temperature propagation would give a visual feedback of irreversible cell damage of the target tissue. Potential temperature features in ultrasound (US) B-Mode image sequences during r...

This work aims to demonstrate the feasibility that haptic information can be acquired from a da Vinci robotic tool using audio sensing according to sensor placement requirements in a real clinical scenario. For that, two potential audio sensor locations were studied using an experimental setup for performing, in a repeatable way, interactions of a...

Longitudinal and perpendicular changes in the vocal fold’s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evalua...

Challenges like interrupted visualization and artifacts are common during interventional surgery while guiding medical interventional devices (MIDs) such as needles, catheters, etc. This proclaims the need of efficient accessories for improving simultaneous targeting and visualization of MIDs during interventional surgeries. Diagnostic devices are...

Epilepsy is a neurological disorder that happens because of the propagation of abnormal signals produced by clusters of neurons in the brain. The majority of those with epileptic seizures can be treated by drug therapies and surgery. However, 25% of the patients with diagnosed epilepsy continue to have seizures. Seizures can cause serious injuries...

The patent illustrates a concept that is a basis for developing a hybrid gamma-ultrasound scanner. This scanner, which is capable of acquiring both physiological and anatomical information, can be held with one hand. This feature of the scanner makes it a suitable device for use in image-guided surgery as well as small-field-of view imaging.

The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with vocal fold cancer, dysplastic lesions, and papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). The combination of contact endoscopy with narrow-band imaging (NBI-CE) allows intraoperatively a...

Minimal invasive device insertion into the soft tissue is a very important medical approach that is helpful for local drug delivery, biopsy, regional anesthesia, blood sampling, and radiofrequency ablation. These methods need to introduce the MID inside the body for exploring the tissue texture pattern. We propose a novel approach by acquiring acou...

Fetal monitoring is commonly based on the joint recording of the fetal heart rate (FHR) and uterine contraction signals obtained with a cardiotocograph (CTG). Unfortunately, CTG analysis is difficult, and the interpretation problems are mainly associated with the analysis of FHR decelerations. From that perspective, several approaches have been pro...

Ultrasound is a useful technique for diagnosing thyroid nodules. Benign and malignant nodules that automatically discriminate in the ultrasound pictures can provide diagnostic recommendations or, improve diagnostic accuracy in the absence of specialists. The main issue here is how to collect suitable features for this particular task. We suggest he...

Cardiotocograph (CTG) is a widely used tool for fetal surveillance during labor, which provides the joint recording of fetal heart rate (FHR) and uterine contraction data. Unfortunately, the CTG interpretation is difficult because it involves a visual analysis of highly complex signals. Recent clinical research indicates that a correct CTG assessme...

In this work we summarize applications of a novel approach for providing complementary information for guiding medical interventional devices (MID) and that have been recently published by our research team. This approach consist of using an audio sensor located in the proximal end of the MID in order to extract meaningful information concerning th...

This paper focuses on studying the time-variant dynamics involved in the foetal heart rate (FHR) response resulting from the autonomic nervous system modulation. It provides a comprehensive analysis of such dynamics by relating the spectral information involved in the FHR signal with foetal physiological characteristics. This approach is based on t...

The location of a puncture needle’s tip and the resistance of tissue against puncture are crucial information for clinicians during a percutaneous procedure. The tip location and needle alignment can be observed by image guidance. Tactile information caused by tissue resistance to rupture, allow clinicians the perception of structural changes durin...