InVision™ System

InnerOptic's innovative InVision System (IVS) provides a "GPS for the Physician," enhancing the physician's ability to use intraoperative ultrasound during abdominal minimally invasive procedures. Described below in detail, the InVision system is available in two configurations:

• IVS for Needle Guidance (IVS-NG)
• IVS for Laparoscopic Surgery (IVS-LS)

InVision™ System for Needle Guidance

A common alternative to the surgical removal of cancerous liver tissue is to use a specialized needle to burn the cancerous tissue using a ablation, either using radiofrequency, microwave or freezing (cryoblation). Ablation is performed with image guidance, as accurate needle placement is crucial. Tumor ablation can be performd percutaneously (i.e. needle-puncture through the skin), during open surgery or laparoscopically. In all cases, ultrasound is often used to identify the tumor and guide the needle to the center of the tumor. However, it is very difficult and error prone to use ultrasound for needle guidance.

The InVision System for Needle Guidance provides needle guidance for percutaneous and open needle interventions (e.g., ablations and biopsies). IVS correlates not only the ultrasound image and the laparoscope's image, but also the needle (shown below), providing the surgeon with clear, real-time feedback on how to accurately place the needle before burning the tissue. IVS highlights whether the needle is in front or behind the ultrasound plane. Also, IVS shows the ablation volume (red sphere below), showing the physician what tissue will be ablated, before the ablation takes place. This provides the physician with the confidence that the tumor is killed, while minimizing damage to healthy tissue.

IVS shows 3D position of the needle, ultrasound image,
ablation volume and needle trajectory on a
stereoscopic display.

InVision™ System for Laparoscopic Surgery

As shown in the video below, IVS addresses the spatial coordination problem inherent with laparoscopic ultrasound. The IVS software continually monitors the positions of the sugical devices. Since IVS knows the spatial relationship between the laparoscopic camera, the laparoscopic ultrasound and any other tracked device (e.g., an ablation needle), IVS can provide the surgeon with a single, integrated, intuitive computer-enhanced display in real time.

InVision enhances abdominal MIS interventions, including laparoscopic cholecystectomy (gall bladder removal) and liver tumor ablation.

In the figure below, the InnerOptic software fuses the video images and the ultrasound image onto a single, easy-to-use integrated video display. This provides the surgeon with a more intuitive and accurate view of the internal anatomy (shown in the color video imagery) with the super-imposed black-and-white ultrasound imagery.

In the video clip below, the surgeon uses IVS with laparoscopic ultrasound to guide the needle to ablate a liver tumor. The red sphere at the tip of the needle shows the predicted

Shown below, the surgeon holds a laparoscope (in his right hand) and a laparoscopic ultrasound (in his left hand).  The IVS integrates the video image with the ultrasound image into a combined video image, shown in in the monitor labeled "Image-Guide Display" in the figure.   

Improving Gall Bladder Removal

The InVision System is highly effective in performing laparoscopic cholecystectomy (gall bladder removal), the most commonly-performed MIS procedure (750,000 per year domestically).  The most common source of injury during the procedure is to the bile duct, and this happens because it is not properly imaged during the operation.  Over 10,000 bile duct injuries occur during LC every year, costing hospitals over $500M in repair costs.

Laparoscopic ultrasound is now promoted as a better alternative to cholangiography (CT-based imaging of the bile duct), as it images the bile duct equally well, does not involve radiation, is less expensive, and requires significantly less time. However, LUS is difficult to use and is in general currently not reimbursed by insurance companies for cholecystectomy.
InnerOptic's IVS, on the other hand, makes LUS considerably easier to use, minimizes costly OR time, and allows a hospital to be reimbursed at higher rate than cholangiography or LUS alone.