Image Guidance and Technological Mediation in Surgery

Iconic Turn – How Images Govern Our Actions (in collaboration with Image-Knowledge-Gestaltung Cluster of Excellence at Humboldt-Universität and Charité Hospital, Berlin)

This research explores the role of medical imaging from a medical media theory perspective through a course called Iconic Turn – How Images Govern Our Actions, taught to medical students at the Charité University Hospital, Berlin.

From initial complaint to working diagnosis and possible intervention, imaging with ever-increasing levels of detail is being used in the consideration of patient symptoms. Surgical options for correcting any anomaly are evaluated by the medical team using specific pathological visualizations alongside the associated contexts, and then discussed with the patient in a kind of benefit-risk assessment. Where an operation is agreed upon, the planning of surgical intervention is aided by image-based surgical planning software, which can for example suggest the best route to the diseased area as well highlight as possible structures at risk. During the operation, surgery makes use of pictorial information in order to carry out actions in a targeted manner. At the furthest extreme, the entire intervention may be planned through images and carried out robotically. Success monitoring after the operation also makes full use of images.

The first, general, objective of the module is to sensitize students to the extraordinary significance of the 'image' in modern medicine and particularly in surgery. Images serve as an imperative impetus to action within the routine of clinical medicine.

The second general objective of the module is to empower future doctors to apply medical imaging in the best interest of their patient. The ability to critically analyze images is a pre-condition for this. Three topics will help to impart this knowledge: first, comparative analysis of the media in question and the associated technical procedures and modalities of representation; second, a historical classification of the aforementioned media and procedures, etc.; and third, an overview of places and times at which images become effective tools. This will enable an understanding of the mechanisms that have implicated images in a range of processes.

The third objective underpinning the module, alongside the fundamental teaching of image analysis, is the mediation of current technical developments in the field of medical imaging – something which must be a continually updated. The focus here is on the increasing synchronization of image and body in 3D; augmented and virtual reality applications; and the progressive distancing of staff and patient in the areas of pre-planning, remote control and robotics.

Students will be expected to acquire the necessary professionalism when working with images so that, both now and in the future, they can make best use of medical imaging opportunities. Theories referred to in the training blocks will be set alongside corresponding clinical case studies as part of the interactive discussion of cases. Supervised patient examinations, patient-side teaching and OR work shadowing will also be offered in relevant areas.

imagINe surgery: Surgical Education and Tool Training in the Digital Age

Our research has been presented through two international symposia called imagINe surgery, that have been organized to present, disseminate, and engage in scholarly debate about the research results.

The follow-up event to the international workshop imagINe surgery: Collaborative Surgical Tool Development in 2017 will focus on the multi-faceted impact of high-tech equipment in operating rooms and perioperative care on surgical education and training. As part of the outcomes of the first imagINe surgery workshop, the organizers have identified the critical role that all stakeholders involved (such as clinicians, engineers, designers, researchers, and to some extent patients as well) should play in identifying technology design priorities. A key aim of this second workshop is to build on that finding.