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L’apport de la cœlioscopie en chirurgie digestive n’est plus à démontrer permettant une diminution de la douleur postopératoire, une reprise de l’autonomie plus rapide et de ce fait de diminuer la durée d’hospitalisation. L’oesophagectomie est une intervention lourde en terme de morbidité pouvant être améliorée par l’abord mini-invasif. Ces dernières années ont vu l’introduction de techniques hybrides où l’un des temps opératoires était réalisé par cœlioscopie ou par thoracoscopie, l’autre étant réalisé par voie ouverte.

Cette année aura été marquée par le début de la chirurgie colorectale assistée par robot au sein des Cliniques universitaires Saint-Luc. La chirurgie assistée par robot est une technique chirurgicale nouvelle qui a été mise au point pour pallier les limitations techniques de la chirurgie laparoscopique. En effet, contrairement aux instruments rectilignes et rigides de la laparoscopie classique, les bras du robot ainsi que ses instruments permettent des mouvements imitant parfaitement ceux du poignet et de la main du chirurgien. Associées à une vision 3D du champ opératoire, à un grossissement de 10 fois et à un filtrage du tremblement physiologique, ces caractéristiques, et d’autres encore, sont la clé d’une chirurgie mini-invasive extrêmement précise et sûre., [Colorectal surgery in the robotic era] The year 2015 has been marked by the initiation of robotic-assisted colorectal surgery at the Cliniques universitaires Saint-Luc. Robotic surgery is a new surgical technology, which attempts to overcome the technical limitations of laparoscopic surgery. Contrary to the rectilinear and rigid instruments used in classical laparoscopy, the robot’s arms and instruments allow for intuitive movements that perfectly mimic those of the surgeon’s wrist and hand. Along with the 3D magnified vision of the operating field and filtering of physiological tremor, these features in addition to others are key to the precision and safety of minimally invasive surgery.

Radiofrequency ablation (RFA) is a minimally invasive treatment for either hepatocellular carcinoma or metastasis liver carcinoma. In order to resect large lesions, the surgeon has to perform multiple time-consuming destruction cycles and reposition the RFA needle for each of them. The critical step in handling a successful ablation and preventing local recurrence is the correct positioning of the needle. For small tumors, the surgeon places the middle of the active needle tip in the center of the tumor under intra-operative ultrasound guidance. When one application is not enough to cover the entire tumor, the surgeon needs to repeat the treatment after repositioning of the needle, but US guidance is obstructed by the opacity stemming from the first RFA application. In this case the surgeon can only rely on anatomical knowledge and the repositioning of the RFA needle becomes a subjective task limiting the treatment accuracy. We have developed a computer assisted surgery guidance application for this repositioning procedure. Our software application handles the complete process from preoperative image analysis to tool tracking in the operating room. Our framework is mostly used for this RFA procedure, but is also suitable for any other medical or surgery application., Doctorat en Sciences de l'ingénieur, info:eu-repo/semantics/nonPublished

Radiofrequency ablation (RFA) is a minimally invasive treatment for either hepatocellular carcinoma or metastasis liver carcinoma. In order to resect large lesions, the surgeon has to perform multiple time-consuming destruction cycles and reposition the RFA needle for each of them. The critical step in handling a successful ablation and preventing local recurrence is the correct positioning of the needle. For small tumors, the surgeon places the middle of the active needle tip in the center of the tumor under intra-operative ultrasound guidance. When one application is not enough to cover the entire tumor, the surgeon needs to repeat the treatment after repositioning of the needle, but US guidance is obstructed by the opacity stemming from the first RFA application. In this case the surgeon can only rely on anatomical knowledge and the repositioning of the RFA needle becomes a subjective task limiting the treatment accuracy. We have developed a computer assisted surgery guidance application for this repositioning procedure. Our software application handles the complete process from preoperative image analysis to tool tracking in the operating room. Our framework is mostly used for this RFA procedure, but is also suitable for any other medical or surgery application., Doctorat en Sciences de l'ingénieur, info:eu-repo/semantics/nonPublished