Sacral nerve stimulation (SNS) is a procedure where an electrode is implanted through the sacral foramina to stimulate the nerve modulating colonic and urinary functions. This practice has been implemented efficiently to treat several pathologies such as fecal incontinence, urinary retention, and constipation. Currently, X-ray fluoroscopy is used during electrode placement to estimate the needle’s location with respect to the sacral foramina (usually S3 or S4). However, this needle insertion is very challenging to surgeons, and several X-ray projections are required to interpret the needle’s position correctly. Furthermore, the need for multiple punctures causes an increase in surgical time and patients’ pain.
In collaboration with Hospital Fundación Jimenez Díaz and Hospital Universitario La Paz, our group is trying to improve SNS procedures by using computer-assisted intervention techniques. In particular, using optical tracking systems, electromagnetic tracking systems, and augmented reality technology.
We have also developed a method de automatically segment the sacral bone using deep learning, in order to speed up this step of the procedures. The method has been presented in Nvidia GTC Conference (details bellow).
- Laura García-Elcano, R. Moreta-Martinez, J. Pascau. Automatic Sacral Bone Segmentation for Needle Trajectory Definition in Sacral Nerve Stimulation using Deep Learning. NVIDIA GTC Conference 2022. https://www.nvidia.com/en-us/on-demand/session/gtcspring22-p42479/
- R. López-Velazco, D. García-Mato, G. Rodríguez-Lozano, M. García-Sevilla, E. Marinetto, D. García-Olmo, M. Desco, M. Ortega-López, J. Pascau. Image Guidance for Sacral Neuromodulation. In: CARS 2017 – Computer Assisted Radiology and Surgery Proceedings of the 31st International Congress and Exhibition Barcelona, Spain, June 20–24, 2017. Int J CARS 12, 105–106 (2017) [doi]
Research supported by projects PI18/01625 and AC20/00102 (Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Asociación Española Contra el Cáncer and European Regional Development Fund “Una manera de hacer Europa”), IND2018/TIC-9753 (Comunidad de Madrid) and project PrePlanRT (ERA Permed).