Engineering and Construction
Project Title: Minimal access pancreatic necrosectomy
Removal of the necrotic pancreas has traditionally been an open-surgery procedure. Recent work has developed minimal-access techniques which have been shown to improve treatment success and reduce morbidity, organ failure and mortality compared with open-surgery (Connor et al. 2005, Raraty et al. 2010). However, the techniques remain limited by the instruments currently available; an example being a rigid nephroscope (designed to access the kidney) with a straight-line profile that offers limited flexibility to manoeuvre around internal organs and access necrotic tissue, a small field of view and an inefficient method of tissue dissection.
The development work to be carried out in this project is intended to address the first and most challenging of these limitations and hence reduce the potential for internal organ injury, shorten hospital stay and improve the success rate of the procedure.
The primary decision factor when determining patient suitability for minimal access necrosectormy is whether straight-line access to the site of necrotic tissue is possible. The proposed device removes this restriction and builds on new innovative technology to create an application-specific pancreascope that can follow a curved pathway, whose profile can be determined from the patients CT scans or during the procedure. The device is therefore expected to make the procedure significantly safer and available to a larger group of patients.
This project concentrates on technology to enable derivation of the best possible path from the insertion point to the surface of the pancreas, while navigating between the sensitive abdominal organs. An automated segmentation method will be developed to analyse 2D CT scans, and use the segmentation result to build 3D maps of the abdominal space.timisation technique to determine the path of least resistance to the pancreas surface will be validated both numerically and experimentally.