Devoto, Laurence; (2024) Clinical application of novel imaging techniques in gastrointestinal surgery. Doctoral thesis (M.D(Res)), UCL (University College London).

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Abstract

This body of work investigates the current standards of imaging in colorectal cancer surgery as well as the subsequent needs of the field based on the limitations of the technology. It then goes on to identify novel and disruptive techniques that can address these requirements and assess their clinical aptitude. We have covered areas within operative planning and assessment, surgical safety, response to treatment, education, training and mentoring. Textural analysis of CT scan data has demonstrated the ability to identify synchronous metastases significantly earlier than current standards with the potential to alter some patient’s course of treatment. The main focus of the work is the introduction of virtual and augmented reality to the medical field. The use of a patient specific three dimensional-model or virtual patient can assist in the planning of surgery through superior interpretation of the anatomy. When combined with the unique surgical rehearsal platform, the operation can be practiced, taught and further investigated with a strong sense of realism. Finally, the headset viewing device provides holographic imagery that aids real-time intraoperative decision making by both surgeons in the operating theatre and remote observers that can be anywhere in the world. There is a strong foundation for this technology within non-medical fields and we have demonstrated a clear level of aptitude and feasibility to allow its adoption.

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